BIS监测下全凭静脉麻醉对青少年复杂牙拔出术术后早期恢复质量的影响  

The effect of total intravenous anesthesia under BIS monitoring on the early recovery of adolescents after complex tooth extraction

作　　者：顾英花 李俊昌 韦银娟 郜鑫 闵红星 GU Yinghua;LI Junchang;WEI Yinjuan;GAO Xin;MIN Hongxing(Clinical Medical School,Ningixa Medical University,Yinchuan 750004,China;Anesthesiology Department,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学临床医学院,宁夏银川750004 [2]宁夏医科大学总医院麻醉科,宁夏银川750004

出　　处：《宁夏医学杂志》2022年第1期42-45,共4页Ningxia Medical Journal

摘　　要：目的评价脑电双频指数(BIS)监测下全凭静脉麻醉对青少年复杂牙拔出术术后早期恢复质量的影响。方法选择行复杂牙拔出术的患者70例,ASA分级Ⅰ~Ⅱ级,性别不限,年龄12~18岁,体重指数(18.5~23.9)kg/m^(2)。采用数字量表法分为2组:BIS监测组(实验组,B组)和非BIS监测组(对照组,N组),每组35例。2组患者均采用全凭静脉麻醉,其中B组在BIS监测下行麻醉诱导及麻醉维持,N组不监测BIS值,根据标准体重及心率血压行麻醉诱导及麻醉维持。观察2组患者睁眼时间、拔管时间、麻醉后监测治疗室(PACU)停留时间、Steward苏醒评分、术后躁动评分、术后恶心呕吐(PONV)评分以及2组患者术前和术后1 d恢复质量量表QoR-40的评分。结果与N组比较,B组患者睁眼时间、拔管时间明显缩短(P<0.05),丙泊酚、瑞芬太尼用量减少(P<0.05);术后1d QoR-40的总评分高(P<0.05)。PACU停留时间、Steward评分、术后躁动评分、PONV评分2组无统计学意义(P>0.05)。N组患者术后1d QoR-40总评分比术前1 d下降(P<0.05);B组患者术后1d QoR-40总评分与术前无统计学意义(P>0.05)。结论青少年行复杂牙拔出术,在BIS监测下行全凭静脉麻醉,不仅用药少,不良反应少,且患者术后第一天恢复质量好。Objective To evaluate the effects of total intravenous anesthesia(TIVA)under BIS monitoring on the early recovery of adolescents after complex tooth extraction.Methods 70 patients with ASA grade Ⅰ~Ⅱ,age 12~18 years old,body mass index 18.5~23.9 kg/m^(2) who underwent complex tooth extraction in the day ward were enrolled into this study.The patients were randomly divided into two groups:BIS monitoring group(group B,n=35)and non-BIS monitoring group(group N,n=35).Both groups of patients underwent TIVA.Group B was monitored by BIS for induction and maintenance of anesthesia.Group N was not monitored for BIS value,and induction and maintenance of anesthesia were performed according to standard body weight,heart rate and blood pressure.The eye-opening time,extubation time,post anesthesia car unit(PACU)stay time,Steward score,postoperative restlessness score,postoperative nausea and vomiting(PONV)score,and a postoperative quality of recovery score the QoR-40 scores of the two groups of patients one day before and after surgery were recorded.Results Compared with group N,the time of eye-opening and extubation in group B were significantly shorter(P<0.05),and the dosage of propofol and remifentanil was reduced(P<0.05);The total score of QoR-40 was high(P<0.05).PACU stay time,Steward score,postoperative restlessness score,PONV score were similar between the two groups(P>0.05).The total QoR-40 score of the patients in group N was lower than that of the preoperative one day after operation(P<0.05);the total QoR-40 score of patients in group B was not different from that before the operation on the first day(P>0.05).Conclusion Adolescents underwent complex tooth extractions under TIVA under BIS monitoring can not only reduce the drug dose and the adverse reactions,but also improve recovery quality on the first day after surgery.

关 键 词：脑电双频指数 青少年 早期恢复质量 

分 类 号：R782.11[医药卫生—口腔医学]