术前给予右美托咪定对小儿七氟烷吸入麻醉期间脑电双频指数的影响：一项随机对照试验。
Effect of preoperative dexmedetomidine administration on the bispectral index in children during sevoflurane inhalation anesthesia: a randomized controlled trial.
作者信息
Xiang Zhen, Wu Lei, Wei Siwei, Yu Eryou, Chen Zheng, Du Zhen
机构信息
Department of Anesthesiology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
出版信息
BMC Anesthesiol. 2025 Feb 14;25(1):72. doi: 10.1186/s12871-025-02946-x.
BACKGROUND
The available data on the effect of dexmedetomidine premedication on anesthesia depth in children during general anesthesia are limited. This study was designed to determine the effect of preoperative dexmedetomidine administration on the bispectral index (BIS) and sevoflurane requirements in children during sevoflurane anesthesia.
METHODS
120 children aged 5 to 12 years undergoing concealed penis repair or hypospadias plastic surgery were randomized to receive preoperative administration of 0.25 µg kg dexmedetomidine, 0.5 µg kg dexmedetomidine, 0.75 µg kg dexmedetomidine, or the same volume of placebo. The primary outcome was the change in the BIS value from before dexmedetomidine administration to 60 min after surgical incision. The secondary outcomes included the end-tidal sevoflurane concentration (ETsevo), hemodynamic data, anesthesia recovery data and intraoperative awareness.
RESULTS
Compared with those in Group C, the BIS values of children in Group D2 and Group D3 were significantly lower during sevoflurane induction and early maintenance (P < 0.017). Moreover, children in Group D2 and Group D3 had a lower ETsevo (P < 0.001) during sevoflurane maintenance than did those in Group C (P < 0.017). There were statistically significant differences in heart rate(P < 0.0001) and mean arterial pressure(P < 0.001) between the groups, but the incidence of bradycardia or hypotension was similar between the groups (p = 0.779 and p = 0.901).
CONCLUSIONS
Children who received 0.5 µg kg or 0.75 µg kg dexmedetomidine preoperatively were more likely to achieve the target depth of anesthesia (BIS less than 60) during anesthesia induction and had lower BIS values during the early stage of anesthesia maintenance.
TRAIL REGISTRATION
The trial is registered with the China Clinical Trials Registry Registration Number: ChiCTR1900026872. Date of registration: 10/24/2019.
背景
关于右美托咪定预处理对儿童全身麻醉期间麻醉深度影响的现有数据有限。本研究旨在确定术前给予右美托咪定对七氟醚麻醉期间儿童脑电双频指数（BIS）及七氟醚需求量的影响。
方法
120例年龄在5至12岁行隐匿阴茎修复术或尿道下裂整形手术的儿童被随机分为四组，分别接受术前给予0.25μg/kg右美托咪定、0.5μg/kg右美托咪定、0.75μg/kg右美托咪定或相同体积的安慰剂。主要观察指标为从给予右美托咪定前至手术切口后60分钟BIS值的变化。次要观察指标包括呼气末七氟醚浓度（ETsevo）、血流动力学数据、麻醉恢复数据及术中知晓情况。
结果
与C组相比，D2组和D3组儿童在七氟醚诱导期和早期维持期的BIS值显著更低（P＜0.017）。此外，D2组和D3组儿童在七氟醚维持期的ETsevo低于C组（P＜0.001）（P＜0.017）。各组间心率（P＜0.0001）和平均动脉压（P＜0.001）存在统计学显著差异，但各组间心动过缓或低血压的发生率相似（p = 0.779和p = 0.901）。
结论
术前接受0.5μg/kg或0.75μg/kg右美托咪定的儿童在麻醉诱导期间更有可能达到目标麻醉深度（BIS小于60），且在麻醉维持早期具有更低的BIS值。
试验注册
本试验在中国临床试验注册中心注册，注册号：ChiCTR1900026872。注册日期：2019年10月24日。
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