Sargin Mehmet, Uluer Mehmet Selcuk, Ozmen Sadık
The Clinic of Anesthesiology and Reanimation, Konya Training and Research Hospital, Konya, Turkey.
Paediatr Anaesth. 2015 Sep;25(9):950-5. doi: 10.1111/pan.12692. Epub 2015 May 13.
General anesthesia is often preferred for dental surgery or rehabilitation in developmentally delayed pediatric patients. Bispectral index monitoring is used to monitor the depth of anesthesia and to ensure early recovery. However, studies on the topic in developmentally delayed pediatric patients are limited.
To evaluate the effects of Bispectral Index Scale (BIS) on hemodynamics and recovery profile in developmentally delayed pediatric patients undergoing dental surgery.
Forty children between the ages of 6-16 years were studied in this prospective and randomized study. The children were randomized into two groups. In Group 1 (n = 20), general anesthesia was maintained with 1-2 minimum alveolar concentration (MAC) of sevoflurane in oxygen by standard practice. In Group 2 (n = 20), the depth of anesthesia was monitored by BIS. BIS values were continuously recorded from awake status to tracheal extubation. The duration of the surgical procedure, anesthesia, postanesthesia care unit (PACU) stay was noted. To evaluate recovery profile, time to spontaneous ventilation, extubation, open eyes, and PACU discharge were also noted.
There were significant differences between recovery times and Non-communicating Children's Pain Checklist - Postoperative Version (NCCPC-PV) scores of two groups. Time to spontaneous ventilation [Difference in means (95% CI); 3.17 (1.79-4.54) P < 0.001], extubation [Difference in means (95% CI); 3.13 (1.66-4.60) P < 0.001], open eyes [Difference in means (95% CI); 3.97 (2.34-5.59) P < 0.001], and PACU stay time [Difference in means (95% CI); 23.55 (18.08-29.01) P < 0.001] were significantly shorter in Group 2.
In conclusion, results suggest that routine BIS monitoring may be beneficial due to its favorable effects on the recovery profile in developmentally delayed pediatric patients.
对于发育迟缓的儿科患者，牙科手术或康复治疗通常更倾向于采用全身麻醉。脑电双频指数监测用于监测麻醉深度并确保早期恢复。然而，关于发育迟缓儿科患者这一主题的研究有限。
评估脑电双频指数（BIS）对接受牙科手术的发育迟缓儿科患者血流动力学和恢复情况的影响。
在这项前瞻性随机研究中，对40名6至16岁的儿童进行了研究。这些儿童被随机分为两组。第1组（n = 20），按照标准操作，使用1 - 2倍最低肺泡有效浓度（MAC）的七氟醚在氧气中维持全身麻醉。第2组（n = 20），通过BIS监测麻醉深度。从清醒状态到气管拔管持续记录BIS值。记录手术过程、麻醉、麻醉后护理单元（PACU）停留的持续时间。为评估恢复情况，还记录了自主通气时间、拔管时间、睁眼时间和PACU出院时间。
两组的恢复时间和非沟通性儿童疼痛清单 - 术后版（NCCPC - PV）评分存在显著差异。第2组的自主通气时间[均值差异（95%置信区间）；3.17（1.79 - 4.54）P < 0.001]、拔管时间[均值差异（95%置信区间）；3.13（1.66 - 4.60）P < 0.001]、睁眼时间[均值差异（95%置信区间）；3.97（2.34 - 5.59）P < 0.001]和PACU停留时间[均值差异（95%置信区间）；23.55（18.08 - 29.01）P < 0.001]明显更短。
总之，结果表明常规BIS监测可能有益，因为它对发育迟缓的儿科患者的恢复情况有积极影响。
