脑状态指数与脑瘫调整手术患儿呼气末七氟醚浓度的相关性研究  

Correlation between cerebral state index and end-tidal concentration of sevoflurane in children with cerebral palsy undergoing adjustment surgery

作　　者：贡瞻 陈卫东 潘璠 高新跃 钱忠心[3] 王谊生[1] GONG Zan;CHEN Weidong;PAN Fan;GAO Xinyue;QIAN Zhongxin;WANG Yisheng(Department of Anesthesiology,Punan Hospital of Pudong New Area in Shanghai,Shanghai,200125;Department of Anesthesiology,the Sixth People′s Hospital in Shanghai,Shanghai,200233;Department of Neurosurgery,Punan Hospital of Pudong New Area in Shanghai,Shanghai,200125)

机构地区：[1]上海市浦东新区浦南医院麻醉科,上海200125 [2]上海市第六人民医院麻醉科,上海200233 [3]上海市浦东新区浦南医院神经外科,上海200125

出　　处：《实用临床医药杂志》2021年第19期20-23,29,共5页Journal of Clinical Medicine in Practice

基　　金：上海市浦东新区卫健委卫生科技项目(面上项目)(PW2016A-26);上海市浦东新区医学学科建设项目(临床高原学科,神经外科)(PWYgy2018-04);上海市医学重点专科建设(第六轮,神经外科)(ZK2019C07)。

摘　　要：目的探讨脑状态指数(CSI)与呼气末七氟醚浓度(C_(ET)Sev)在脑瘫患儿七氟醚全身麻醉期间的相关性。方法选择80例择期下肢调整手术的脑瘫患儿,采用七氟醚全身麻醉和常规监测,持续监测C_(ET)Sev和CSI。于诱导前(T_(0))、喉罩置入后(T_(1))和C_(ET)Sev 0.8%(T_(2))、C_(ET)Sev 1.2%(T_(3))、C_(ET)Sev 1.6%(T_(4))、C_(ET)Sev 2.0%(T_(5))、C_(ET)Sev 2.4%(T_(6))、C_(ET)Sev 2.8%(T_(7))时,以及停吸七氟醚(T_(8))和下降期CETSev 1.4%(T_(9))、C_(ET)Sev 1.2%(T_(1)0)、C_(ET)Sev 1.0%(T_(1)1)、C_(ET)Sev 0.8%(T_(1)2)、C_(ET)Sev 0.6%(T_(1)3)、C_(ET)Sev 0.4%(T_(1)4)和喉罩拔除前(T_(1)5)、喉罩拔除后(T_(1)6)时,记录C_(ET)Sev和CSI值。分析C_(ET)Sev和CSI的相关性。结果在C_(ET)Sev上升期(T_(0)~T_(7)),T_(2)~T_(7)的CSI低于T_(0),差异有统计学意义(P<0.05);CSI与C_(ET)Sev呈负相关(r=-0.890,P<0.001)。在C_(ET)Sev下降期(T_(8)~T_(1)6),T_(9)~T_(1)6的CSI高于T_(8),差异有统计学意义(P<0.05);CSI与C_(ET)Sev呈负相关(r=-0.889,P<0.001)。结论在脑瘫调整手术患儿C_(ET)Sev的上升期和下降期,CSI与C_(ET)Sev均呈显著负相关,故可通过CSI指导全身麻醉期间的七氟醚精准用药。Objective To investigate the correlation between cerebral state index(CSI)and end-tidal concentration of sevoflurane(C_(ET)Sev)in children with cerebral palsy during sevoflurane general anesthesia.Methods Eighty children with cerebral palsy for selective lower limb adjustment surgery were selected.Sevoflurane general anesthesia and routine monitoring were performed,and C_(ET)Sev as well as CSI were continuously monitored.Before induction(T_(0)),after laryngeal mask implantation(T_(1)),C_(ET)Sev 0.8%(T_(2)),C_(ET)Sev 1.2%(T_(3)),C_(ET)Sev 1.6%(T_(4)),C_(ET)Sev 2.0%(T_(5)),C_(ET)Sev 2.4%(T_(6)),C_(ET)Sev 2.8%(T_(7)),stop taking sevoflurane(T_(8))and declining stages including C_(ET)Sev 1.4%(T_(9)),C_(ET)Sev 1.2%(T_(1)0),C_(ET)Sev 1.0%(T_(1)1),C_(ET)Sev 0.8%(T_(1)2),C_(ET)Sev 0.6%(T_(1)3),C_(ET)Sev 0.4%(T_(1)4),before(T_(1)5)and after(T_(1)6)laryngeal mask removal,the values of C_(ET)Sev and CSI were recorded.The correlation between C_(ET)Sev and CSI introduction was analyzed.Results During the rising period of C_(ET)Sev(T_(0) to T_(7)),the CSI of T_(2) to T_(7) was significantly lower than that of T_(0)(P<0.05);CSI was negatively correlated with C_(ET)Sev(r=-0.890,P<0.001).During the decreasing period of C_(ET)Sev(T_(8) to T_(1)6),CSI values of T_(9) to T_(1)6 were significantly higher than that of T_(8)(P<0.05);CSI was negatively correlated with C_(ET)Sev(r=-0.889,P<0.001).Conclusion There is a significant negative correlation between CSI and C_(ET)Sev in the rising and descending period of C_(ET)Sev in children with cerebral palsy undergoing palsy adjustment surgery.Therefore,CSI can be used to guide the accurate use of sevoflurane during general anesthesia.

关 键 词：七氟醚 脑状态指数 脑瘫 小儿 浓度 

分 类 号：R742[医药卫生—神经病学与精神病学] R614[医药卫生—临床医学]