CAJ | 학술논문

目的：评估小儿耳鼻喉手术中脑电双频指数（BIS）指导下丙泊酚复合瑞芬太尼全凭静脉闭环与开环的效果。方法选择择期行小儿扁桃体腺样体切除小儿患者40例，随机分为闭环组（T组）和开环组（C组），每组20例。2组患者均采用静脉诱导方式，诱导后T组采用系统自动调节血浆靶控浓度方式，C组采用根据术中BIS值人工调节血浆靶控浓度方式。分别于麻醉前（T0）、插管即刻（T1）、插管后5 min（T2）、10 min（T3）、15 min（T4）、30 min（T5）、拔除气管插管（T6）各时间点记录无创血压、心率、脉搏血氧饱和度、心电图、BIS、人工调节丙泊酚靶控浓度的次数、苏醒时间。结果 T组患者丙泊酚应用总量小于C组患者，总体用量降低约9.83%；2组患者瑞芬太尼用量无统计学差异；BIS值波动及术中血流动力学方面，T组患者较C组稳定。结论小儿耳鼻喉手术中丙泊酚—瑞芬太尼闭环麻醉安全易行，可调控性强，应广泛使用。
목적：평고소인이비후수술중뇌전쌍빈지수（BIS）지도하병박분복합서분태니전빙정맥폐배여개배적효과。방법선택택기행소인편도체선양체절제소인환자40례，수궤분위폐배조（T조）화개배조（C조），매조20례。2조환자균채용정맥유도방식，유도후T조채용계통자동조절혈장파공농도방식，C조채용근거술중BIS치인공조절혈장파공농도방식。분별우마취전（T0）、삽관즉각（T1）、삽관후5 min（T2）、10 min（T3）、15 min（T4）、30 min（T5）、발제기관삽관（T6）각시간점기록무창혈압、심솔、맥박혈양포화도、심전도、BIS、인공조절병박분파공농도적차수、소성시간。결과 T조환자병박분응용총량소우C조환자，총체용량강저약9.83%；2조환자서분태니용량무통계학차이；BIS치파동급술중혈류동역학방면，T조환자교C조은정。결론소인이비후수술중병박분—서분태니폐배마취안전역행，가조공성강，응엄범사용。
Objective To evaluate the application of propfol?remifentanil closed?loop and opened?loop anesthesia in children otorhinolaryngologic operation under BIS monitoring. Methods Fourty children underwent elective children tonsillectomy and adenoidectomy were recruited for the study and randomly divided into two groups:closed?loop group(group T)and opened?loop group(group C),with 20 children each. The two groups all received total intravenous induction,then the subjects of closed?loop group were administrated with a method of system automatic regulation of plasma target control and the opened?group cases underwent manual adjustment of plasma target control method according to the BIS value during op?eration. The variables of non?invasive blood pressure(BP),heart rate(HR),pulse oxygen saturation(SpO2),electrocardiogram(ECG),bispec?tral index(BIS),the number of times the manual adjustment of propfol target control applied,and recovery time,were recorded respectively at the time points of before anesthesia(T0),immediately after intubation(T1),5 min after intubation(T2),10 min after(T3),15 min after(T4),30 min after(T5)and the removal of endotracheal intubation(T6). Results The total dosage of propfol in group T was less than the dosage in group C with dosage decrease of 9.83%;there was no significant statistical difference of the total dosage of remifentanil. Conclusion The use of propfol?remi?fentanil closed?loop anesthesia in children otorhinolaryngologic operation is safe,easy,and of strong controllability,which should be widely promoted.