Zhang Jian-min, Wang Fang, Xin Zhong, Lü Hong
Department of Anesthesiology, Beijing Children Hospital, Beijing 100045, China.
Zhonghua Yi Xue Za Zhi. 2008 Nov 11;88(41):2904-6.
To investigate the effectiveness of bispectral index (BIS) during intravenous anesthesia with remifentanil and propofol in children.
Forty ASAI or II pediatric patients undergoing selective surgery were divided into 4 equal groups according to age: Group A (< or = 3 m), Group B (> 3 m - 2 y), Group C (2 - 6 y), and Group D (6 - 12 y). In all groups, anesthesia was induced with remifentanil 1 microg/kg and propofol 3 mg/kg, maintained with remifentanil 0.25 microg . kg(-1) . min(-1) and propofol 6 mg/kg(-1) . h(-1). Scores of BIS and University of Michigan sedation scale (UMSS) were recorded before induction (T(1)), after induction (T(2)), at intubation (T(3)), at skin incision (T(4)), at stopping of anesthetics (T(5)), at spontaneous respiration (T(6)), and at extubation (T(7)). The time between stopping anesthetics and spontaneous respiration and the time of extubation were recorded respectively.
(1) The BIS values at T(2), T(3), T(4), T(5), and T(6) were lower compared with that at T(1) in all groups (all P < 0.01). (2) There was no significant difference in the spontaneous respiration recovery time among all groups. The extubation time of Group A was much longer than those of Groups B, C, and D (all P < 0.01). (3) The UMSS scores at T(1) and T(7) in all groups were all lower than those at T(3).
BIS effectively monitors the depth of intravenous anesthesia with remifentanil and propofol.
探讨双谱指数（BIS）在小儿瑞芬太尼与丙泊酚静脉麻醉中的有效性。
40例择期手术的美国麻醉医师协会（ASA）Ⅰ或Ⅱ级小儿患者，根据年龄分为4组，每组10例：A组（≤3个月）、B组（＞3个月至2岁）、C组（2至6岁）、D组（6至12岁）。所有组均采用1μg/kg瑞芬太尼和3mg/kg丙泊酚诱导麻醉，以0.25μg·kg⁻¹·min⁻¹瑞芬太尼和6mg·kg⁻¹·h⁻¹丙泊酚维持麻醉。记录诱导前（T₁）、诱导后（T₂）、插管时（T₃）、切皮时（T₄）、停麻醉药时（T₅）、自主呼吸时（T₆）及拔管时（T₇）的BIS值和密歇根大学镇静评分（UMSS）。分别记录停麻醉药至自主呼吸的时间和拔管时间。
（1）所有组T₂、T₃、T₄、T₅及T₆时的BIS值均低于T₁时（均P＜0.01）。（2）各组自主呼吸恢复时间差异无统计学意义。A组拔管时间明显长于B、C、D组（均P＜0.01）。（3）所有组T₁及T₇时的UMSS评分均低于T₃时。
BIS能有效监测瑞芬太尼与丙泊酚静脉麻醉的深度。
