摘要
目的观察小儿丙泊酚镇静状态下在不同BIS值拔出气管插管时的血流动力学变化及麻醉并发症,选择最佳拔管时机的BIS值。方法选择全麻患儿200例,随机分为A组(拔管时BIS值60～65)、B组(拔管时BIS值～70)、C组(拔管时BIS值～75)、D组(拔管时BIS值～80),每组50例。全部患儿依次静注阿托品、芬太尼、丙泊酚、罗库溴铵麻醉诱导,术中持续静注丙泊酚、瑞芬太尼麻醉,维持术中BIS值45～55。术毕无吸痰等外界刺激情况下,各组在不同BIS值下吸痰拔管,观察并记录各组患儿的血流动力学变化、术后并发症及清醒时间。结果 A组舌后坠发生率(24%)、呼吸抑制发生率(44%)明显高于其他3组(P﹤0.05),而D组患儿躁动发生率(38%)、恶心呕吐发生率(14%)最高。B、C组患儿血流动力学反应轻,呼吸系统影响小,术后麻醉并发症少。结论在镇痛充分的前提下,丙泊酚镇静拔管时BIS值66～75范围内拔管较为适宜;BIS值71～75范围内拔管最为安全平稳。
Objective To evaluate the value of bispectral index （BIS） monitoring as an indicator for extubation se- dation level during total intravenous anesthesia. Methods Two-hundred children （1.5-13.5 years old） were randomly di- vided into four groups with 50 cases in each. All cases kept BIS 40-60 during the operation. Group A kept BIS 60-65, and Group B -70, Group C -75, Group D -80 till extubation. Results Thirty-four patients in Group A had dropped tongue, tenesmus, short of breath. Twenty-six children in Group D had restless, nausea and vomiting. Patients in Group B and C had less evident cardiovascular responses and less effect on respiratory system and less complication after extuba- tion. Conclusions The BIS level of 70-75 is a good sedation level for extubation.
出处
《北京医学》
CAS
2012年第11期975-978,共4页
Beijing Medical Journal
关键词
脑电双频指数
儿童
拔管
丙泊酚
Bispectral index（BIS） Children Extubation Propofol
