脑电双频指数监测在小儿臂丛神经阻滞复合二异丙酚全麻中的应用

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1、脑电双频指数监测在小儿臂丛神经阻滞复合二异丙酚全麻中的应用中文摘要目的小儿上肢显微血管外科手术时间长，麻醉深度管理困难。对4,JL臂丛神经阻滞复合二异丙酚靶控输注全身麻醉，观察小儿基本情况以监测麻醉深度，确定最佳靶浓度与脑电双频指数(bispectralindex，BIS)区间。方法将80例手指手术患儿随机分为4组，氯胺酮诱导，臂丛神经阻滞后靶控输注二异丙酚(靶浓度分别设定为2．0、2．5、3．0、3．5pg／m1)。记录患儿术中体动、血氧饱和度(bloodoxygensaturation，Sp02)<95％的次数，术后苏醒时间和恶心呕吐(po

2、stoperativenauseaandvomiting，PONV)情况，以及术中相应BIS值。结果BIS值与二异丙酚的靶控浓度呈良好负相关(P

3、Ig／ml组有显著差异(P<0．05)。术后恶心呕吐4组无明显差异(P>O．05)。结论小儿臂丛神经

4、阻滞复合二异丙酚靶控输注全身麻醉，二异丙酚靶浓度设定为3．Oug／m1，麻醉深度最佳，术后苏醒较快。BIS值维持在40,---,50之间，有助于麻醉深度的监测。硕士研究生曲彦亮(麻醉学)指导教师王世端教授周赞宫副教授关键词：脑电双频指数；异丙酚；麻醉深度监测；小儿；手部手术lIILII11111Ullllllllllllll11111111111111111Y2338776TheusageofBISmonitoringinpediatrichandoperationswithbrachialplexusblockcombinedwithprop

5、ofolsedationAbstractObjectiveThepediatricoperationofmicrovascularsurgeryonupperlimbwastime—consumingandtheanesthesiadepthwasdifficulttomanage．Toinvestigatetheanesthesiadepthofchildrenandtoobservetheclinicaleffectofbispectralindex03IS)inpediatrichandoperationswithbrachialplex

6、usblockcombined、析nltargetcontrolledinfusionofpropof01．MethodEightypediatricpatientswithf'mgerssurgerywereselectedandrandomlydividedequallyintofour黟．oups．Afterintramuscularofketamine，brachialplexusblockWasperformedwithnervestimulator,andthentargetcontrolledinfusionofpropofolf

7、orsedation．Thetargetconcentrationofpropofolwassetwith2．0，2．53．0and3．5Il∥锄．TheBISscore，bodymovement,timesofsp02lowerthan95％，awakentimeandpostoperativenauseaandvomitingofeachchildwa．erecorded．ResultThereiSasignificantnegativecorrelationbetweenBISscoreandthetargetconcentrationo

8、fpropofol(P<0．01)．Effect-siteconcentrationof3．0pg／mlgroupreachedthetargetconcentrationinstantlywithBISvalueof494-6，thenremainedwithBISvalueof464-5for30mininthesteadystate．Comparedwith3．5pg／mlgroup，significantlesstimesofsp02lowerthan95％，andsborterpostoperativerecoverytimein3．

9、0p咖lgroupwereobserved(P<0．05)．Wealsofoundlesstimesofbodymovementduringopera