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在脑电双频指数监测下,使用丙泊酚和瑞芬太尼静脉麻醉治疗不同年龄段儿童。

Treatment of different-aged children under bispectral index monitoring with intravenous anesthesia with propofol and remifentanil.

作者信息

Zhang J-M, Wang F, Xin Z, Zi T-T, Lv H

机构信息

Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, Beijing, China.

出版信息

Eur Rev Med Pharmacol Sci. 2015 Jan;19(1):64-9.

Abstract

OBJECTIVE

To investigate the changes in bispectral index (BIS) to determine the controllability and safety of intravenous anesthesia with propofol and remifentanil in different-aged children.

PATIENTS AND METHODS

Forty cases of ASA levels I or II were divided into four groups (A group, ≤ three months old; B group, three months to two years old; C group, two years to six years old; and D group, six years to 12 years old) with 10 cases in each group. Propofol and remifentanil were used in anesthesia induction and maintenance. Hemodynamic changes, BIS values, and sedation scores during T1, T2, T3, T4, T5, T6, and T7, as well as spontaneous breathing recovery and extubation times, were recorded.

RESULTS

Compared with that at T1, the BIS values at T2, T3, T4, T5, and T6 decreased (p < 0.01). SBP, DBP, and HR also decreased (p < 0.01). Compared with the other groups, the extubation time of A group increased (p < 0.01). At T2, T3, T4, T5, T6, and T7, the BIS values of A group were all less than those of C group (p < 0.01).

CONCLUSIONS

Anesthesia is stable and safe when the same unit doses of propofol and remifentanil are administered to different-aged children. In infants under three months, the BIS values were lower, with prolonged palinesthesia time.

摘要

目的

研究脑电双频指数(BIS)的变化,以确定丙泊酚和瑞芬太尼静脉麻醉在不同年龄段儿童中的可控性和安全性。

患者与方法

40例美国麻醉医师协会(ASA)分级为Ⅰ或Ⅱ级的患者分为四组(A组,≤3个月;B组,3个月至2岁;C组,2岁至6岁;D组,6岁至12岁),每组10例。在麻醉诱导和维持过程中使用丙泊酚和瑞芬太尼。记录T1、T2、T3、T4、T5、T6和T7期间的血流动力学变化、BIS值和镇静评分,以及自主呼吸恢复时间和拔管时间。

结果

与T1时相比,T2、T3、T4、T5和T6时的BIS值降低(p<0.01)。收缩压、舒张压和心率也降低(p<0.01)。与其他组相比,A组的拔管时间延长(p<0.01)。在T2、T3、T4、T5、T6和T7时,A组的BIS值均低于C组(p<0.01)。

结论

对不同年龄段儿童给予相同单位剂量的丙泊酚和瑞芬太尼时,麻醉稳定且安全。在3个月以下的婴儿中,BIS值较低,苏醒时间延长。

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