Lamas Adelaida, López-Herce Jesús, Sancho Luis, Mencía Santiago, Carrillo Angel, Santiago Maria José, Martínez Vicente
Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Anesth Analg. 2008 Feb;106(2):426-32, table of contents. doi: 10.1213/ane.0b013e3181602be1.
We analyzed the values of the bispectral index (BIS) and midlatency auditory evoked potentials (MLAEP) and their correlation with the modified Ramsay score (RS) during wakefulness and natural sleep in healthy children without pharmacological sedation.
Fifty-three healthy children younger than 2-yr-old were studied. Children were evaluated simultaneously using the modified RS, the BIS, and MLAEPs. Each patient was studied only once. The correlation and agreement were studied. The correlation among the three methods was determined using the Spearman Rank Correlation test and the agreement among the methods was assessed using by Cohen's Kappa test.
There was a moderate-to-good correlation (r) among the three methods (P = 0.01): BIS and MLAEP (r = 0.574), BIS and RS (r = -0.504), and MLAEP and RS (r = -0.624). However, the level of agreement (kappa) was only poor to fair: BIS and MLAEP (kappa = 0.392), BIS and RS (kappa = 0.270), and MLAEP and RS (kappa = 0.409). All the correlations were lower in children between 1 and 6 mo-of-age. When the children were asleep (RS: 3-5), the BIS values were higher in children younger than 1 mo-of-age than in children older than 6 mo-of-age (P after Bonferroni correction = 0.028).
The BIS, MLAEP, and RS have a good correlation in children younger than 2 yr not receiving pharmacological sedation, though the level of agreement was poor.
我们分析了在未使用药物镇静的健康儿童清醒和自然睡眠期间，脑电双频指数（BIS）和中潜伏期听觉诱发电位（MLAEP）的值及其与改良Ramsay评分（RS）的相关性。
研究了53名2岁以下的健康儿童。使用改良RS、BIS和MLAEP对儿童进行同步评估。每位患者仅研究一次。研究相关性和一致性。使用Spearman等级相关检验确定三种方法之间的相关性，并使用Cohen's Kappa检验评估方法之间的一致性。
三种方法之间存在中度至良好的相关性（r）（P = 0.01）：BIS与MLAEP（r = 0.574）、BIS与RS（r = -0.504）以及MLAEP与RS（r = -0.624）。然而，一致性水平（kappa）仅为差至一般：BIS与MLAEP（kappa = 0.392）、BIS与RS（kappa = 0.270）以及MLAEP与RS（kappa = 0.409）。1至6月龄儿童的所有相关性均较低。当儿童入睡时（RS：3 - 5），1月龄以下儿童的BIS值高于6月龄以上儿童（Bonferroni校正后P = 0.028）。
在未接受药物镇静的2岁以下儿童中，BIS、MLAEP和RS具有良好的相关性，尽管一致性水平较差。
