小儿在使用2%丙泊酚和瑞芬太尼全身麻醉苏醒过程中脑电双频指数的变化。

Changes of bispectral index during recovery from general anesthesia with 2% propofol and remifentanil in children.

作者信息

Park Hye-Jin, Kim Yong Lak, Kim Chong Sung, Kim Seong Deok, Kim Hee-Soo

机构信息

Department of Anesthesiology, College of Medicine, Eulji University, Korea.

出版信息

Paediatr Anaesth. 2007 Apr;17(4):353-7. doi: 10.1111/j.1460-9592.2006.02096.x.

DOI:10.1111/j.1460-9592.2006.02096.x

PMID:17359404

Abstract

BACKGROUND

The bispectral (BIS) index is a pharmacodynamic measure of the effect of anesthesia on the central nervous system. The aim of this study was to investigate the relationship between BIS index and predicted plasma concentration of propofol delivered by target controlled infusion (TCI) during emergence in children.

METHODS

With approval of IRB, 30 patients (2-7 years) were included in this study. Anesthesia was with TCI propofol 3-5 microg.ml(-1) and remifentanil 7.5 ng.ml(-1) to maintain BIS 40-60 and the propofol concentration was fixed at 3 microg.ml(-1) Remifentanil infusion was stopped 10 min before the end of surgery. BIS values were recorded after reducing propofol in decrement of 0.2 microg.ml(-1). BIS values were checked when spontaneous respiration occurred and children were able to obey a command (eye opening or hand grasping).

RESULTS

Spearman's correlation analysis showed negative correlation between BIS and propofol plasma concentration (r = -0.559, P < 0.001). When respiration returned, mean BIS was 77.2 +/- 5.3 and propofol plasma concentration 1.6 +/- 0.3 microg.ml(-1) and when a verbal command was obeyed, BIS was 82.4 +/- 5.6 and propofol plasma concentration 1.5 +/- 0.3 microg.ml(-1).

CONCLUSIONS

In preschool children, BIS moderately correlated with the predicted plasma concentration of propofol.

摘要

背景

脑电双频指数（BIS）是一种评估麻醉对中枢神经系统作用的药效学指标。本研究旨在探讨小儿苏醒期BIS指数与靶控输注（TCI）丙泊酚预测血浆浓度之间的关系。

方法

经机构审查委员会（IRB）批准，本研究纳入30例2至7岁患儿。采用TCI丙泊酚3 - 5μg·ml⁻¹和瑞芬太尼7.5 ng·ml⁻¹维持麻醉，使BIS维持在40 - 60，丙泊酚浓度固定为3μg·ml⁻¹。手术结束前10分钟停止输注瑞芬太尼。以0.2μg·ml⁻¹的递减幅度降低丙泊酚剂量后记录BIS值。当患儿出现自主呼吸且能听从指令（睁眼或握手）时检查BIS值。

结果

Spearman相关性分析显示BIS与丙泊酚血浆浓度呈负相关（r = -0.559，P < 0.001）。自主呼吸恢复时，平均BIS为77.2 ± 5.3，丙泊酚血浆浓度为1.6 ± 0.3μg·ml⁻¹；能听从语言指令时，BIS为82.4 ± 5.6，丙泊酚血浆浓度为1.5 ± 0.3μg·ml⁻¹。