BIS指导下七氟烷吸入在小儿腹腔镜疝囊高位结扎术中的应用价值  

Application value of sevoflurane inhalation under high-frequency ligation of laparoscopic hernia sac in children under the guidance of BIS

作　　者：曹川 董自强 郑敬[1] 黄泽宗 陈玲[1] 罗潇 CAO Chuan;DONG Zi-Qiang;ZHENG Jing(The First People′s Hospital of Jiujiang,Jiujiang 332000,Jiangxi,China)

机构地区：[1]九江市第一人民医院,江西九江332000 [2]赣州市人民医院

出　　处：《吉林医学》2024年第9期2053-2057,共5页Jilin Medical Journal

基　　金：九江市留学人员创业创新支持计划项目[项目编号:JLCB20210501]。

摘　　要：目的:探讨脑电双频指数(BIS)指导下七氟烷吸入麻醉在小儿腹腔镜疝囊高位结扎术中的应用的临床价值。方法:选取2020年6月~2022年10月九江市第一人民医院拟实施七氟烷吸入麻醉下腹腔镜疝囊高位结扎术的小儿120例,采用随机数字表法分为BIS组60例(BIS术中维持在40~50)、对照组60例(由麻醉师根据患儿情况调节麻醉药物使用);对比BIS组和对照组患儿不同时间的心率(HR)、平动动脉压(MAP)、血氧饱和度(SpO_(2))及BIS组和对照组患儿的意识消失时间、喉罩置入时间、拔除喉罩时间、苏醒时间、麻醉复苏室(PACU)停留时间、七氟烷使用量、不良反应情况。结果:经重复测量的方差分析法分析,BIS组和对照组的HR、MAP组间差异具有统计学意义(P<0.05),BIS组的HR、MAP测定值波动较对照组小;BIS组和对照组的SpO_(2)测定值差异无统计学意义(P>0.05);BIS组和对照组的意识消失时间、喉罩置入时间组间差异无统计学意义(P>0.05),BIS组的苏醒时间、拔除喉罩时间、PACU停留时间、七氟烷使用量测定值低于对照组,差异有统计学意义(P<0.05);BIS组患者的不良反应发生率(6.67%)明显低于对照组(20.00%),差异有统计学意义(P<0.05)。结论:BIS指导下七氟烷吸入麻醉在小儿腹腔镜疝囊高位结扎术中的应用可减小七氟烷用量、更好的维持术中血流动力学的稳定。Objective To explore the clinical value of sevoflurane inhalation anesthesia under the guidance of bispectral index(BIS)in the high ligation of laparoscopic hernia sac in children.Method 120 children in our hospital with laparoscopic high ligation of sacral aspiration under sevoflurane inhalation anesthesia were enrolled from June 2020 to October 2022.60 patients in the BIS group(40 to 50 in BIS)and 60 patients in the control group were randomly selected.The anesthesiologist adjusted the use of anesthetic drugs according to the condition of the child;the heart rate(HR),blood pressure(MAP),pulse oximetry(SpO_(2)),the disappearance time of the consciousness of the two groups,and the laryngeal mask were compared between the two groups.Time,removal of laryngeal mask time,recovery time,PACU residence time,sevoflurane use,adverse reactions.Results After repeated measures of analysis of variance analysis,the differences between the HR and MAP groups in the BIS group and the control group were statistically significant(P<0.05),and the fluctuations in the HR and MAP values in the BIS group were smaller than those in the control group;There was no significant difference in the measured value of SpO_(2) between the BIS group and the control group(P>0.05).There was no significant difference between the BIS group and the control group in the disappearance time of consciousness and the time of laryngeal mask placement(P>0.05).Time,removal of laryngeal mask time,PACU residence time,sevoflurane use measured value was lower than the control group(P<0.05);BIS group patients had an adverse reaction rate of 6.67%,which was lower than the control group(20.00%)(P<0.05).Conclusion Under the guidance of BIS,the application of sevoflurane inhalation anesthesia in the high ligation of laparoscopic hernia sac in children can reduce the dose of sevoflurane and better maintain the stability of intraoperative hemodynamics.

关 键 词：脑电双频指数 七氟烷 吸入麻醉 小儿 腹腔镜疝囊高位结扎术 

分 类 号：R656.2[医药卫生—外科学]