中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
3期
305-306
,共2页
沈艳喜%黄乐林%邓小兵%李伟%胡光秀
瀋豔喜%黃樂林%鄧小兵%李偉%鬍光秀
침염희%황악림%산소병%리위%호광수
心脏缺损,先天性%放射学,介入性%脑电双频指数%麻醉药,静脉%麻醉恢复期
心髒缺損,先天性%放射學,介入性%腦電雙頻指數%痳醉藥,靜脈%痳醉恢複期
심장결손,선천성%방사학,개입성%뇌전쌍빈지수%마취약,정맥%마취회복기
Heart defects,congenital%Radiology,interventional%Bispectral index%Anesthetics,intravenous%Anesthesia recovery period
目的 研究脑电双频指数(BIS)指导快通道麻醉在小儿先天性心脏病(先心病)介入治疗中的应用.方法 将拟行介入治疗的40例先心病患儿,完全随机分为观察组和对照组,各20例.观察组在BIS调控下丙泊酚(2 mg/kg,维持BIS值在40～60,手术结束前20 min,BIS维持在60～ 70)持续泵入；对照组由麻醉医师根据临床经验判断麻醉深度并调整用药.记录2组丙泊酚总用量、意识恢复时间、拔管时间及不良反应发生率.结果 观察组的丙泊酚用量[(145±16) mg]明显少于对照组[(196±33)mg],组间差异有统计学意义(P＜0.05)；意识恢复时间[(3.1±1.2)min]、拔管时间[(5.1±1.6)min]均明显短于对照组[意识恢复时间:(8.2±3.1)min,拔管时间:(12.1 ±4.2)min],组间差异均有统计学意义(均P＜0.01)；观察组不良反应发生率[5.0％(1/20)]低于对照组[45.0％ (9/20)],差异有统计学意义(P＜0.05).结论 BIS指导快通道麻醉可让介入治疗的先心病患儿术后尽早苏醒,有利于术后恢复.
目的 研究腦電雙頻指數(BIS)指導快通道痳醉在小兒先天性心髒病(先心病)介入治療中的應用.方法 將擬行介入治療的40例先心病患兒,完全隨機分為觀察組和對照組,各20例.觀察組在BIS調控下丙泊酚(2 mg/kg,維持BIS值在40～60,手術結束前20 min,BIS維持在60～ 70)持續泵入；對照組由痳醉醫師根據臨床經驗判斷痳醉深度併調整用藥.記錄2組丙泊酚總用量、意識恢複時間、拔管時間及不良反應髮生率.結果 觀察組的丙泊酚用量[(145±16) mg]明顯少于對照組[(196±33)mg],組間差異有統計學意義(P＜0.05)；意識恢複時間[(3.1±1.2)min]、拔管時間[(5.1±1.6)min]均明顯短于對照組[意識恢複時間:(8.2±3.1)min,拔管時間:(12.1 ±4.2)min],組間差異均有統計學意義(均P＜0.01)；觀察組不良反應髮生率[5.0％(1/20)]低于對照組[45.0％ (9/20)],差異有統計學意義(P＜0.05).結論 BIS指導快通道痳醉可讓介入治療的先心病患兒術後儘早囌醒,有利于術後恢複.
목적 연구뇌전쌍빈지수(BIS)지도쾌통도마취재소인선천성심장병(선심병)개입치료중적응용.방법 장의행개입치료적40례선심병환인,완전수궤분위관찰조화대조조,각20례.관찰조재BIS조공하병박분(2 mg/kg,유지BIS치재40～60,수술결속전20 min,BIS유지재60～ 70)지속빙입；대조조유마취의사근거림상경험판단마취심도병조정용약.기록2조병박분총용량、의식회복시간、발관시간급불량반응발생솔.결과 관찰조적병박분용량[(145±16) mg]명현소우대조조[(196±33)mg],조간차이유통계학의의(P＜0.05)；의식회복시간[(3.1±1.2)min]、발관시간[(5.1±1.6)min]균명현단우대조조[의식회복시간:(8.2±3.1)min,발관시간:(12.1 ±4.2)min],조간차이균유통계학의의(균P＜0.01)；관찰조불량반응발생솔[5.0％(1/20)]저우대조조[45.0％ (9/20)],차이유통계학의의(P＜0.05).결론 BIS지도쾌통도마취가양개입치료적선심병환인술후진조소성,유리우술후회복.
Objective To investigate the value of bispectral index (BIS) in fast tracking cardiac anesthesia for interventional treatment of pediatric congenital heart disease (CHD).Methods Forty pediatric patients with CHD were randomly divided into the observation group (n =20) and the control group (n =20).Patients in the observation group were treated by intensive propofol pump according to the BIS.The dose was 2 mg/kg and the value of BIS remained 40-60,while the value of BIS increased to 60-70 during the last 20 minutes of surgery.The dose of propofol in patients of the control group was adjusted by the anesthestists according to their clinical experience.The total dose of propofol,the time of awakening,the time of removed tube and the rate of side effects were observed.Results The propofol dose in the observation group was markedly lower than that in the control group (145 ± 16 mg vs 196 ± 33 mg).The observation group achieved shorter time of awakening and removed tube than the control group (3.1 ±1.2 min vs 8.2 ±3.1 min; 5.1 ± 1.6 min vs 12.1±4.2 min).Also,the rate of side effects in the observation group was 5.0％,which was significantly lower than that of the control group (45.0％).Conclusion BIS-guided fast tracking cardiac anesthesia for interventional treatment can reduce the awaken time and enhance the postoperative recovery of the pediatric patients with CHD.
