麻醉深度指数监测在小儿七氟烷麻醉中的应用  

Application of Cerebral State Index on Child in Sevoflurane Anesthesia

作　　者：邓佳[1] 许婷[1] 蒋璐[1] 刘云飞[1] 王燮[1] 

机构地区：[1]四川省医学科学院四川省人民医院麻醉科,四川成都610072

出　　处：《四川医学》2016年第11期1233-1235,共3页Sichuan Medical Journal

摘　　要：目的探讨麻醉深度指数（CSI）指导小儿七氟醚麻醉的临床意义。方法 2-12岁、儿外科行泌尿系手术患儿60例随机均分为CSI组和对照组。CSI组依据CSI值调整七氟醚吸入浓度,目标CSI术中保持在40-60,术末15min保持60-75;对照组根据临床经验调节七氟醚吸入浓度。记录术中和术末呼气末七氟醚浓度、CSI值,同时记录HR、MAP、苏醒时间、气管拔管时间、PACU停留时间。结果 CSI组患儿术中及术末呼气末七氟醚浓度明显低于对照组,CSI值明显高于对照组,差异有统计学意义（P〈0.05）。CSI组患儿苏醒时间、拔管时间、PACU停留时间均短于对照组,差异有统计学意义（P〈0.05）。CSI组患者术后出现2例恶心呕吐,对照组出现7例恶心呕吐;两组患儿均未出现术中知晓,CSI组不良反应发生率明显低于对照组,差异有统计学意义（P〈0.05）。结论小儿七氟醚麻醉中监测CSI能减少七氟醚用量和缩短苏醒时间,减少不良事件的发生。Objective To explore the clinical significance of cerebral state index（ CSI） on child in sevoflurane anesthesia. Methods 60 cases of 2 - 12 years old children who were going to do urinary surgery were divided into CSI group and control group randomly and equally. In the CSI group the inhalation concentration of sevoflurane was adjusted based on CSI value,targeting at 40 ~ 60 during the operation and 60 - 75 during the last 15 minutes of the operation; While in the control group inhalation concentration of Sevoflurane was adjusted according to clinical experience. The concentration of sevoflurane and CSI values during the operation and during the last 15 minutes of the operation,HR,MAP,waking time,tracheal extubation time,PACU residence time were recorded.Results The concentration of sevoflurane during the operation and during the last 15 minutes of the operation of the CSI group was obviously lower than the control group,and the CSI values were significantly higher than the control group,statistically significant（ P〈0. 05）. The waking time,extubation time,and PACU residence time of the CSI group was shorter than the control group,and the difference was statistically significant（ P〈0. 05）. There were 2 cases of postoperative nausea and vomiting in the CSI group,while there were 7 cases in control group; Intra-operative awareness were not present in either of the two groups. The incidence of adverse reactions in the CSI group was obviously lower than the control group,and the difference was statistically significant（ P 〈0. 05）. Conclusion Monitoring CSI during Sevoflurane anesthesia in pediatric can reduce the dosage of sevoflurane,shorten the time of awakening and reduce the occurrence of adverse events.

关 键 词：麻醉深度指数 七氟醚 儿童 

分 类 号：R726.1[医药卫生—儿科]