儿童七氟醚吸入麻醉下顺式阿曲库铵对熵指数的影响  

Effect of cisatracurium on entropy index of children undergoing sevoflurane anesthesia

作　　者：曹静[1] 张晓彤[1] 扈大为[1] 朱雯竞[1] 

机构地区：[1]首都医科大学附属北京口腔医院麻醉科,100050

出　　处：《中华医学杂志》2017年第20期1568-1571,共4页National Medical Journal of China

基　　金：首都医科大学基础与临床科研合作基金（JL1479）

摘　　要：目的探讨儿童七氟醚吸入麻醉下顺式阿曲库铵对熵指数的影响。方法选取2015年6至11月北京口腔医院择期行唇腭裂修复术的患儿45例，美国麻醉医师协会（ASA）分级I-Ⅱ级，年龄8—24个月，分别维持不同的呼气末七氟醚浓度（CETSev），根据CETSev将患儿分为3组。I组：CETSev为2．5％（15例）；Ⅱ组：CETSev为3．0％（16例）；m组：CETSev为3．5％（14例）。患儿进入手术室后，采用Datex—Ohmeda麻醉工作站对尺神经行4个成串刺激（TOF）监测，拇内收肌依次出现的4个肌颤搐分别记录为T1、T2、T3、T4；熵指数模块监测状态熵（SE）、反应熵（RE）的水平。采用6％七氟醚高流量吸入诱导，患儿入睡后，氧气（O：）流量调至2L／min，分别维持3组C。，Sev为2．5％、3．0％、3．5％，并保持10min以上后，分别给予顺式阿曲库铵0．15mg／kg，记录不同组别患儿顺式阿曲库铵给药前（t，）、T，抑制50％（t：）、T。抑制75％（t，）、T1抑制100％（t4）时SE、RE水平。结果在t1、t2、t3、t4时点，I组患儿SE值分别为（55±19）、（53±20）、（48±18）、（43±16），差异有统计学意义（F=3．881，P〈0．05）；Ⅱ组患儿sE值分别为（42±19）、（41±21）、（39±18）、（31±15），差异有统计学意义（F=3．465，P〈0．05）；Ⅲ组患儿SE值分别为（34±11）、（33±16）、（33±14）、（52±13），差异无统计学意义（F=0．162，P〉0．05）。在t1、t2、t3、t4时点，I组RE值分别为（54±13）、（48±11）、（34±13）、（30±13），差异有统计学意义（F=36．975，P〈0．01）；Ⅱ组RE值分别为（43±13）、（38±13）、（33±12）、（28±11），差异有统计学意义（F=12．438，P〈0．01）；Ⅲ组RE值分别为（34±10）、（33±11）、（31±12）、（25±11），差异有统计学意义（F=6．019，P〈0．01）。I、Ⅱ、Ⅲ组患儿RE值在顺式阿曲库铵给�Objective To investigate the effect of cisatracurium on entropy index of children undergoing sevoflurane anesthesia. Methods Forty-five child patients （ASA I - U ） who underwent cleft lip and palate repair surgery in Beijing Stomatological Hospital were selected from June to November in 2015. They aged from 8 to 24 months and were randomly divided into 3 groups, as well as maintained at different end-tidal sevoflurane concentrations （CETSev） , respectively. The CETSeV in Group I was 2.5%, with a total number of 15 cases. The CETSeV in Group l± was 3.0% , with a total number of 16 cases. The CETSeV in Group Ill was 3.5% , with a total number of 14 cases. After the child patients were sent into operating room, their ulnar nerves underwent train-of-four stimulation （TOF） inspection using Datex- Ohmeda anesthesia workstation. The four muscle twitches orderly occurring on abductor pollicis muscle were recorded as T±, T2 , T3 and T4 , respectively. The level of state entropy （SE） and reactive entropy （RE） was monitored by the entropy index module. 6% of sevoflurane high-flow inhalation was used to induce children＇s sleep, and the oxygen flow was adjusted to 2 L/min. Also, the CxTSev in 3 groups maintained at 2.5% , 3.0% and 3.5% , respectively, which lasted for more than 10 min. Then, they were administered with 0. 15 mg/kg cisatracurium, and the level of SE and RE in 3 groups was recorded when they were before the drug delivery of cisatracurium （ t1 ）, 50% inhibition of T1 （ t2 ）, 75% inhibition of T1 （ t3 ） and 100% inhibition of T1 （t4）, respectively. Results At the time of t1, t2 , t3 and t4, the SE values in Group I were （55 ± 19） , （53 ±20）, （48 ± 18） and （43 ± 16）, respectively, and the differences were statistically significant （F =3. 881, P 〈0. 05）. The SE values in Group I1 were （42 ± 19）, （41 ±21 ）, （39 ± 18）, （31 ± 13 ）, and the differences were statistically significant （ F = 3. 463, P 〈 0. 05 ）. The SE values in Gr

关 键 词：阿曲库铵 熵指数 七氟醚 麻醉 儿童 

分 类 号：R726.1[医药卫生—儿科]