CAJ | 학술논문

【目的】探讨脑电双频指数（BIS ）监测在小儿斜视手术可唤醒麻醉中的应用价值。【方法】选择斜视患儿80例随机分为BIS组和对照组，采用瑞芬太尼和丙泊酚给患儿行可唤醒麻醉，BIS组根据BIS值调整瑞芬太尼和丙泊酚的输注速度，对照组根据麻醉师经验、临床体征（如血压，HR ，肢动）调整丙泊酚、瑞芬太尼的输注速度。记录麻醉诱导前（T1）、牵拉眼肌时（T2）、唤醒前（T3）、唤醒成功时（T4）、手术结束时（T5）时脉搏血氧饱和度（SpO2）、平均动脉压（MAP）及心率（HR）；记录唤醒时间（从停用镇静药至唤醒成功时间）、麻醉苏醒时间、丙泊酚、瑞芬太尼用量；比较两组患者呼吸抑制、心动过缓、不自主体动、术中知晓、术后恶心呕吐等不良反应的发生情况。【结果】所有患儿各时点MAP、HR和SpO2均在正常范围；与对照组比较，BIS组患儿瑞芬太尼、丙泊酚用量减少，唤醒时间、麻醉苏醒时间缩短；与BIS组比较，对照组呼吸抑制，心动过缓发生率高（P ＜0．05），但两组不自主体动、术中知晓、恶心、呕吐的发生率差异无统计学意义（P ＞0．05）。【结论】在小儿斜视手术中BIS监测指导可精确控制麻醉深度，术中唤醒快，减少麻醉药用量和麻醉并发症。
【목적】탐토뇌전쌍빈지수（BIS ）감측재소인사시수술가환성마취중적응용개치。【방법】선택사시환인80례수궤분위BIS조화대조조，채용서분태니화병박분급환인행가환성마취，BIS조근거BIS치조정서분태니화병박분적수주속도，대조조근거마취사경험、림상체정（여혈압，HR ，지동）조정병박분、서분태니적수주속도。기록마취유도전（T1）、견랍안기시（T2）、환성전（T3）、환성성공시（T4）、수술결속시（T5）시맥박혈양포화도（SpO2）、평균동맥압（MAP）급심솔（HR）；기록환성시간（종정용진정약지환성성공시간）、마취소성시간、병박분、서분태니용량；비교량조환자호흡억제、심동과완、불자주체동、술중지효、술후악심구토등불량반응적발생정황。【결과】소유환인각시점MAP、HR화SpO2균재정상범위；여대조조비교，BIS조환인서분태니、병박분용량감소，환성시간、마취소성시간축단；여BIS조비교，대조조호흡억제，심동과완발생솔고（P ＜0．05），단량조불자주체동、술중지효、악심、구토적발생솔차이무통계학의의（P ＞0．05）。【결론】재소인사시수술중BIS감측지도가정학공제마취심도，술중환성쾌，감소마취약용량화마취병발증。
[Objective] To explore the application of bispectral index (BIS) monitoring in wake‐up anes‐thesia during pediatric strabismus surgery .[Methods] A total of 80 children of strabismus were randomly di‐vided into BIS and control groups .And wake‐up anesthesia was performed with remifentanil and propofol .In BIS group ,the infusion rates of remifentanil and propofol were adjusted according to BIS .In control group , the determinants were handling experience and clinical signs [e .g .blood pressure ,heart rate (HR) and ex‐tremity movement] .The values of mean arterial pressure (MAP) ,HR and (oxygen saturation) SPO2 before induction of anesthesia (T1 ) ,pulling of eye muscle (T2 ) ,before wake‐up (T3 ) ,successful wake‐up (T4 ) and at the end of surgery (T5 ) .And wake‐up time (from withdrawing sedatives to successful wake‐up) ,anesthe‐sia time and doses of propofol and remifentanil were recorded .And respiratory depression ,bradycardia ,invol‐untary body movements ,intraoperative awareness and postoperative onsets of nausea and vomiting were com‐pared .[Results]At all timepoints ,MAP ,HR and SpO2 stayed within normal ranges .As compared with con‐trol group ,the doses of remifentanil and propofol decreased while wake‐up and awareness times declined in BIS group;as compared with BIS group ,respiratory depression and bradycardia were more frequent in control group ( P <0 .05) .No significant inter‐group differences existed in body movement ,intraoperative awareness or onsets of nausea and vomiting ( P>0 .05) .[Conclusion]During pediatric strabismus surgery ,BIS monito‐ring guidance may accurately control the depth of anesthesia .And it has the advantages of quick wake‐up ,low‐er anesthetic doses and fewer complications .