Dominguez Troy E, Helfaer Mark A
Department of Anesthesiology and Critical Care Medicine, University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, PA 19141, USA.
Pediatr Emerg Care. 2006 Dec;22(12):815-21; quiz 822-4. doi: 10.1097/01.pec.0000203821.02045.69.
Sedation is a key component in the management of pediatric patients both in the pediatric emergency department (PED) and pediatric intensive care unit (PICU) for the treatment of pain and anxiety. Bispectral (BIS) index monitoring has been developed to help clinicians assess degree of hypnosis with anesthesia and may be useful in these environments.
Literature searches were conducted through MEDLINE for case series/reports, retrospective studies, and randomized trials that evaluate the validity and applications of BIS monitoring in the PED and PICU.
Most of the studies are case series or retrospective studies in children. There are several prospective studies assessing validation of the monitor in children. Only a few studies have been performed that assess the influence of monitoring on outcomes in these environments.
Bispectral values correlate fairly well with commonly used clinical sedation scores, but more variability in the scores has been observed at lighter levels of sedation. More studies are needed to assess the value of titrating sedation in the PED and PICU within specific BIS parameters to reduce morbidity and costs associated with over-sedation.
在儿科急诊科（PED）和儿科重症监护病房（PICU）中，镇静是治疗小儿患者疼痛和焦虑的关键组成部分。双谱指数（BIS）监测已被开发出来，以帮助临床医生评估麻醉时的催眠程度，在这些环境中可能会有所帮助。
通过MEDLINE进行文献检索，查找评估BIS监测在PED和PICU中的有效性及应用的病例系列/报告、回顾性研究和随机试验。
大多数研究是针对儿童的病例系列或回顾性研究。有几项前瞻性研究评估了该监测仪在儿童中的有效性。仅有少数研究评估了监测对这些环境中治疗结果的影响。
双谱值与常用的临床镇静评分有较好的相关性，但在较浅镇静水平时，评分的变异性更大。需要更多研究来评估在特定BIS参数范围内滴定镇静在PED和PICU中的价值，以降低与过度镇静相关的发病率和成本。
