Bhardwaj Neerja, Yaddanapudi Sandhya
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Paediatr Anaesth. 2010 Feb;20(2):160-7. doi: 10.1111/j.1460-9592.2009.03240.x.
To evaluate the impact of bispectral index (BIS) monitoring on the consumption of propofol and recovery from anesthesia compared to the standard clinical practice in children.
Titrating propofol administration using BIS reduces its requirement and shortens the recovery from anesthesia in adults. However, there is still mixed evidence for utility of anesthesia depth monitors in reducing anesthesia requirement in children.
METHODS/MATERIALS: A prospective randomized study was conducted in 50 ASA I children of 2-12 years, randomly assigned into standard practice (SP) or BIS group. After induction with propofol, anesthesia was maintained with 150 microg x kg(-1) x min(-1) propofol infusion. The propofol infusion rate was altered by 20 microg x kg(-1) x min(-1) to maintain the systolic blood pressure within 20% of the baseline (SP group) or BIS value between 45 and 60 (BIS group). The rate of propofol infusion was reduced by 50% about 15 min before the end of surgery. The amount of propofol used and the times from stopping the propofol infusion to eye opening, extubation, response to commands and attaining Steward score of 6 were recorded.
There was no evidence of a difference in the mean propofol consumption in the two groups (BIS 232.6 +/- 136.7 mg, SP 250.8 +/- 118.2 mg). The intraoperative hemodynamics and BIS values were similar in the two groups. There was no evidence for a difference between groups in the mean times from termination of anesthetic to eye opening, extubation, response to commands and to achieve a Steward Recovery score of 6.
Our study showed no benefit of BIS-guided propofol administration on anesthetic consumption or recovery compared to standard anesthetic practice.
与儿童的标准临床实践相比，评估脑电双频指数（BIS）监测对丙泊酚用量及麻醉苏醒的影响。
使用BIS滴定丙泊酚给药可减少其用量，并缩短成人的麻醉苏醒时间。然而，关于麻醉深度监测仪在减少儿童麻醉用药方面的效用，仍存在不一致的证据。
方法/材料：对50名年龄在2至12岁的ASA I级儿童进行了一项前瞻性随机研究，随机分为标准实践组（SP）或BIS组。丙泊酚诱导麻醉后，以150μg·kg⁻¹·min⁻¹的丙泊酚输注维持麻醉。丙泊酚输注速率每20μg·kg⁻¹·min⁻¹进行调整，以维持收缩压在基线值的20%以内（SP组）或BIS值在45至60之间（BIS组）。手术结束前约15分钟，丙泊酚输注速率降低50%。记录丙泊酚用量以及从停止丙泊酚输注至睁眼、拔管、对指令有反应和达到Steward评分6分的时间。
两组间丙泊酚平均用量无差异（BIS组232.6±136.7mg，SP组250.8±118.2mg）。两组术中血流动力学和BIS值相似。两组从麻醉结束至睁眼、拔管、对指令有反应以及达到Steward苏醒评分6分的平均时间无差异。
我们的研究表明，与标准麻醉实践相比，BIS引导下的丙泊酚给药在麻醉用药或苏醒方面并无益处。
