意识指数对经鼻右美托咪定在婴幼儿超声心动图镇静深度的预测价值  

Predictive value of consciousness index in sedation depth in infants and children with intranasal dexmedetomidine during echocardiography

作　　者：黄雅莹 罗昊 黄俊祥 宋兴荣[1] 谭永红 李碧莲 HUANG Yaying;LUO Hao;HUANG Junxiang;SONG Xingrong;TAN Yonghong;LI Bilian(Department of Anesthesiology,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属广州市妇女儿童医疗中心麻醉与围术期科,广州510120

出　　处：《实用医学杂志》2023年第1期66-70,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:81901385)。

摘　　要：目的探讨意识指数(index of consciousness,IoC)对不同剂量经鼻给予右美托咪定在婴幼儿超声心动图检查中镇静深度的预测价值。方法选择门诊镇静下行经胸超声心动图检查的非紫绀型先天性心脏病患儿254例,分别经鼻给予右美托咪定3μg/kg(A组)和4μg/kg(B组)。并监测镇静前(T_(0))、检查前(T_(1))、检查中(T_(2))、检查后(T_(3))、及出室时(T_(4))IoC值。利用相关性分析及绘制ROC曲线的方式分析IoC、镇静评分、体动评分及行为评分对镇静深度的预测价值,计算ROC曲线下面积。结果与A组比较,B组镇静成功率显著提高(P<0.05);且B组T_(1)、T_(2)、T_(3)时间点的IoC值显著降低(P<0.05)。IoC值与镇静评分呈显著负相关(r=-0.792,P<0.01),与行为评分呈正相关(r=0.429,P<0.01)。ROC分析显示,相较于其他监测指标,IoC对镇静深度具有更好的预测价值。结论与镇静评分、行为评分相比,IoC对婴幼儿超声心动图检查的镇静深度有更好的预测价值。Objective To investigate the value of index of consciousness(IoC)in predicting the sedation depth in infants and children with different doses of intranasal dexmedetomidine during echocardiography.Methods A total of 254 children patients with non-cyanotic congenital heart disease undergoing transthoracic echocardiography were divided into group A(intranasal dexmedetomidine 3μg/kg,n=127)and group B(intranasal dexmedetomidine 4μg/kg,n=127).And IoC values were monitored before sedation(T_(0)),before examination(T_(1)),during examination(T_(2)),after examination(T_(3)),and when leaving the room(T_(4)).Correlation analysis and receiver-operating characteristic(ROC)curve were used to analyze the predictive value of IoC,The University of Michigan Sedation Scale(UMSS)score,body movement score and behavior score for the sedation depth,and the area under the ROC curve was calculated.Results The sedation success rate in group B was significantly higher than that in group A(P<0.05).The IoC value at T_(1),T_(2),T_(3)in group B was significantly lower than that in group A(P<0.05).Correlation analysis showed that IoC value was negatively correlated with UMSS score(r=-0.792,P<0.01),but positively with behavior score(r=0.429,P<0.01).ROC analysis showed that IoC had a better predictive value for sedation depth than other monitoring indicators.Conclusion Compared with sedation score and behavior score,IoC has better predictive value for the depth of sedation in infant and children echocardiography.

关 键 词：意识指数 婴幼儿 右美托咪定 镇静深度 

分 类 号：R614.1[医药卫生—麻醉学] N31[医药卫生—外科学] R741.04[医药卫生—临床医学]