基于脑电信息样本熵计算的麻醉深度指数在小儿扁桃体/腺样体切除术中的应用  

Application of anesthesia consciousness index based on electrocardiography information sample entropy in pediatric patients who underwent tonsillectomy and adenoidectomy

作　　者：李姣阳 杨玉峰 曾毅 Li Jiaoyang;Yang Yufeng;Zeng Yi(Department of Anesthesiology,Xijing Hospital Afiliated to the Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学附属西京医院麻醉科,西安710032

出　　处：《国际麻醉学与复苏杂志》2022年第8期802-806,共5页International Journal of Anesthesiology and Resuscitation

基　　金：陕西省自然科学基金重点项目(2021JZ33)。

摘　　要：目的探讨基于脑电信息样本熵计算的麻醉深度指数(depth of anesthesia index,AI)在小儿扁桃体/腺样体切除术中的应用.方法选择择期行扁桃体/腺样体切除术的患儿124例,年龄3~10岁,按随机数字表法分为试验组(E组)和对照组(C组),每组62例.两组患儿均采用丙泊酚-瑞芬太尼复合麻醉,E组根据AI调节麻醉深度,维持AI在40~60,C组根据血压、心率变化调节麻醉深度.记录两组患儿入室(T_(1))、诱导前(T_(2))、插管前(T_(3))、插管后1min(T_(4))、插管后3 min(T_(5))、插管后5 min(T_(6))、手术开始(T_(7))、扁桃体切除(T_(8))、腺样体刮除(T_(9))、手术结束(T_(10)、苏醒(T_(11)、拔管(T_(12)时的MAP、心率、AI;记录两组患儿苏醒时间、拔管时间、丙泊酚及瑞芬太尼用量;记录两组患儿术后30 min、术后2 h的小儿苏醒期谵妄量表(Pediatric Anes-thesia Emergence Delirium,PAED)评分及不良反应发生情况.结果T_(7)~T_(10)时E组心率、MAP、AI均高于C组(P<0.05);E组苏醒时间、拔管时间短于C组(P<0.05),丙泊酚用量少于C组(P<0.05);两组患儿不良反应发生情况及术后30 min、术后2 h PAED评分比较,差异均无统计学意义(P>0.05).结论AI监测有助于减少术中静脉麻醉药丙泊酚用量、缩短患儿苏醒时间及拔管时间,可安全用于儿童.Objective To explore the clinical application of depth of anesthesia index(Al)based on electroencephalograhpy information sample entropy in pediatric patients who underwent tonsillectomy and adenoidectomy.Methods A total of 124 children aged 3-10 years who underwent tonsil adenoidectomy were admited to this study.According to random number table method,they were divided into experimental group(group E)and control group(group C),with 62 cases in each group.Both groups received total intravenous anesthesia with propofol and remifentanil.Group E adjusted the depth of anesthesia according to the AI value to maintain the index between 40-60,group C adjusted the depth of anesthesia based on the change in blood pressure and heart rate.The changes in mean arterial pressure(MAP),heart rate,and AI were monitored at the following time points:entering the operating room(T_(1)),before induction(T_(2)),before intubation(T_(3)),I min after intubation(T_(4)),3 min afer intubation(T_(5)),5 min after intubation(T_(6)),at the beginning of surgery(T_(7)),immediately after tonsils removed(T_(8)),immediately after adenoidectomy(T_(9)),at the end of the surgery(T_(10),upon recovery from anesthesia(T_(11),and tracheal extubation(T_(12).Besides,time to recovery from anesthesia,extubation time,total doses of propofol and remifentanil,the Pediatric Anesthesia Emergence Delirium(PAED)scores at 30 min and 2 h after the operation,and the incidences of postoperative complications were also monitored in the two groups.Results The heart rate,MAP,and Al in group E were higher than those in group C during T_(7)-T_(10)(P<0.05),the time to recovery from anesthesia and extubation time of group E were shortened(P<0.05),and the dose of propofol was lower in group E as compared to that of group C(P<0.05).There was no significant diference in postoperative complications,and PAED scores between the two groups 30 min and 2 h after the operation(P>0.05).Conclusions Al monitor helps reduce the amount of propofol usage in intravenous anesthesia and shortens t

关 键 词：麻醉深度 麻醉 全身 扁桃体切除术 腺样体切除术 丙泊酚 

分 类 号：R726.1[医药卫生—儿科]