Işik Berrin, Tüzüner Tamer, Tezkirecioglu Melih, Oztaş Nurhan
Anesthesiology and Reanimation Specialist, Gazi University, Faculty of Dentistry, Department Oral and Maxillofacial Surgery, Ankara, TURKEY.
Eur J Dent. 2007 Oct;1(4):240-5.
To determine whether bispectral analysis (BIS) changes during nitrous oxide (N(2)O) sedation in anxious children undergoing extraction of primary teeth.
In this prospective study 45, ASA physical status I children, aged between 7 to 12 years and scheduled for primary teeth extraction under N(2)O/O(2) sedation are included. At baseline (T0) and during the sedation procedure (T1-6); BIS levels, Ramsay Sedation Scores (RSS), oxygen saturation (Sp0(2)), and heart rate (HR) were recorded at one-minute intervals. Forty percent N(2)O in O(2) was given by a nasal hood, and N(2)O concentration was enhanced to 60% in a two-minute period. Paired measurements of BIS levels with Observer's Assessment of Alertness and Sedation (OAA/S) scores were obtained during sedation procedure.
Since 5 patients refused application of the nasal hood, a total 40 of the original 45 subjects completed the study. Mean age and weight of the children were 9.5 +/- 1.4 years and 23.7 +/- 9.7 kg, respectively. Nitrous oxide inhalation produced no changes in BIS levels despite a sedation level in OAA/S scores were observed at 40-60% N(2)O concentrations.
BIS values do not change during N(2)O/O(2) sedation and the BIS monitor is not appropriate to evaluate the depth of sedation provided by N(2)O/O(2) during primary teeth extraction in children.
确定在接受乳牙拔除术的焦虑儿童中，氧化亚氮（N₂O）镇静期间脑电双频指数（BIS）是否发生变化。
本前瞻性研究纳入了45例ASA身体状况为I级、年龄在7至12岁、计划在N₂O/O₂镇静下进行乳牙拔除的儿童。在基线（T0）和镇静过程中（T1 - 6）；每隔1分钟记录BIS水平、 Ramsay镇静评分（RSS）、血氧饱和度（SpO₂）和心率（HR）。通过鼻罩给予40%的N₂O与O₂混合气体，并在两分钟内将N₂O浓度提高到60%。在镇静过程中，将BIS水平与观察者警觉与镇静评估（OAA/S）评分进行配对测量。
由于5名患者拒绝使用鼻罩，最初的45名受试者中共有40名完成了研究。儿童的平均年龄和体重分别为9.5±1.4岁和23.7±9.7kg。尽管在N₂O浓度为40 - 60%时观察到OAA/S评分处于镇静水平，但吸入氧化亚氮并未使BIS水平发生变化。
在N₂O/O₂镇静期间，BIS值不变，且BIS监测仪不适用于评估儿童乳牙拔除术中N₂O/O₂所提供的镇静深度。
