CAJ | 학술논문

目的探讨七氟醚吸入全醉下不同年龄婴幼儿脑电双频指数(BIS)监测的敏感性,以进一步拓展BIS的使用范围.方法将年龄3~72个月(平均37个月)、ASA I级行小儿腹股沟区手术的60例婴幼儿按年龄分为3组,每组20例,A组<12个月,B组12~36个月,C组36~72个月.所有患儿均采用七氟醚吸入全麻复合髂腹下-髂腹股沟神经阻滞(INB)麻醉,手术切皮后调节呼气末七氟醚浓度(Etsevo)为3.0%,并逐渐递减为2.5%、2.0%、1.5%,各维持5min.此后术中根据体动或心率(HR)变化增减七氟醚吸入浓度.缝皮前调节Etsevo为1.5%,手术结束时停止七氟醚吸入,面罩吸纯氧,氧流量为6L/min,术中以托下颌扣面罩法保持气道通畅.全程监测并记录BIS、Etsevo、HR.结果在Etsevo为3.0%~1.5%时,3组患儿BIS与Etsevo均呈负相关(r=-0.273、-0.691、-0.748,P<0.05或0.01),其中C组相关性高于B组和A组;BIS与HR均呈正相关(r=0.254、0.402、0.547,P<0.05或0.01);Etsevo与HR均呈负相关(r=-0.261、-0.533、-0.783,P<0.05或0.01).结论婴幼儿在七氟醚吸入麻醉下BIS监测值与麻醉深度相关,且其相关性随年龄增长而增大.
목적탐토칠불미흡입전취하불동년령영유인뇌전쌍빈지수(BIS)감측적민감성,이진일보탁전BIS적사용범위.방법장년령3~72개월(평균37개월)、ASA I급행소인복고구구수술적60례영유인안년령분위3조,매조20례,A조<12개월,B조12~36개월,C조36~72개월.소유환인균채용칠불미흡입전마복합가복하-가복고구신경조체(INB)마취,수술절피후조절호기말칠불미농도(Etsevo)위3.0%,병축점체감위2.5%、2.0%、1.5%,각유지5min.차후술중근거체동혹심솔(HR)변화증감칠불미흡입농도.봉피전조절Etsevo위1.5%,수술결속시정지칠불미흡입,면조흡순양,양류량위6L/min,술중이탁하합구면조법보지기도통창.전정감측병기록BIS、Etsevo、HR.결과재Etsevo위3.0%~1.5%시,3조환인BIS여Etsevo균정부상관(r=-0.273、-0.691、-0.748,P<0.05혹0.01),기중C조상관성고우B조화A조;BIS여HR균정정상관(r=0.254、0.402、0.547,P<0.05혹0.01);Etsevo여HR균정부상관(r=-0.261、-0.533、-0.783,P<0.05혹0.01).결론영유인재칠불미흡입마취하BIS감측치여마취심도상관,차기상관성수년령증장이증대.
Objective To evaluate the correlation of bispectral index value (BIS) with inhaled sevoflurane concentration in children of different ages. Methods Sixty children undergoing inguinal surgery with ASA I were divided into three age groups (n=20 in each group):group A (<12 months), group B (≥12 to≤36 months, group C (>36 to≤72 months). Al the patients were anesthetized with inhaled sevoflurane combined with ilioinguinal-iliohypogastric nerve block. After the surgical incision, the end-tidal sevoflurane concentration (Etsevo) was adjusted to 3%, and then gradual y decreased to 2.5%, 2.0%, and 1.5% for each 5 min. Then increased or decreased the Etsevo based on the monitored vital signs during the operation. It was decreased to 1.5% before the skin suture and stopped while the operation was finished. The BIS values were recorded with ASPECT XP BIS monitor;the Etsevo and HR were recorded as wel . Results While Etsevo was 3%~1.5%, the BIS values were negatively related to the Etsevo in three groups, and the correlation coefficient (r) in groups A, B and C and was -0.273,-0.691 and -0.748,re-spectively (P<0.05 or 0.01). The BIS value was positively correlated with HR in groups A, B and C(r=0.254,P<0.05;0.402, P<0.01 and 0.547,P<0.01, respectively);the Etsevo was negatively correlated with HR (r=-0.261, P<0.05;-0.533, P<0.01 and-0.783, P<0.01, respectively). Conclusion Under sevoflurane inhaled anesthesia, the BIS value is correlated with the depth of anesthesia in infants and young children, and the correlation degree is increased with the age of children.