脑电双频指数监测小儿丙泊酚复合瑞芬太尼静脉麻醉维持剂量的临床研究

发布时间：2018-06-17 23:00

本文选题：脑电双频指数 + 丙泊酚　；参考：《中国医科大学学报》2016年01期

【摘要】：目的通过脑电双频指数(BIS)监测丙泊酚复合瑞芬太尼小儿静脉麻醉,探索丙泊酚的术中维持剂量。方法选择全凭静脉麻醉下行小儿扁桃体或腺样体切除术患儿60例,ASAⅠ或Ⅱ级。将患儿随机分为P4组(丙泊酚初始剂量4 mg·kg~(-1)·h~(-1))和P6组(丙泊酚初始剂量6 mg·kg~(-1)·h~(-1)),每组30例。采用BIS监测术中的麻醉深度,根据BIS值(维持在40~60)调整术中丙泊酚的维持剂量,同时将瑞芬太尼的剂量维持在0.05~0.1μg·kg~(-1)·h~(-1)。分别观察并记录2组丙泊酚剂量调整的次数和累计用量。结果 2组麻醉诱导平稳,无插管反应发生。P4组和P6组麻醉中丙泊酚麻醉维持平均剂量分别为(9.23±2.49)和(11.25±3.17)mg·kg~(-1)·h~(-1)。结论应用BIS监测麻醉深度,可减少术中丙泊酚的用量,且诱导、插管、拔管时机的选择更加恰当,血流动力学的波动也更小。应用丙泊酚复合瑞芬太尼(0.05~0.1μg·kg~(-1)·h~(-1))全凭静脉麻醉行小儿扁桃体或腺样体切除术,合适的丙泊酚维持剂量为(10.13±2.76)mg·kg~(-1)·h~(-1)。
[Abstract]:Objective to investigate the intraoperative maintenance dose of propofol combined with remifentanil in children by bispectral index (BIS). Methods 60 children with tonsillectomy or adenoidectomy were treated with total intravenous anesthesia. The children were randomly divided into P4 group (initial dose of propofol 4 mg / kg) and P6 group (initial dose of propofol 6 mg / kg ~ (-1) with 30 cases in each group. The depth of anesthesia was monitored by BIS. The maintenance dose of propofol and remifentanil were adjusted according to the BIS value (maintained at 40 / 60) and remifentanil was maintained at 0. 05 ~ 0. 1 渭 g 路kg ~ (-1) 路h ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1). The times and accumulative dosage of propofol dose adjustment in two groups were observed and recorded. Results the anesthesia induction was stable in the two groups. The average maintenance doses of propofol anesthesia in group P4 and P6 were 9.23 卤2.49 and 11.25 卤3.17)mg 路kg-1, respectively. Conclusion the use of BIS to monitor the depth of anesthesia can reduce the dosage of propofol during operation, and the timing of induction, intubation and extubation is more appropriate, and the fluctuation of hemodynamics is smaller. Propofol combined with remifentanil (0. 05 渭 g / kg) was used for tonsillectomy or adenoidectomy in children by intravenous anesthesia. The appropriate maintenance dose of propofol was 10. 13 卤2.76)mg / kg ~ (-1) 路h ~ (-1).
【作者单位】：第四军医大学西京医院麻醉科;中国医科大学附属盛京医院麻醉科;
【基金】：国家自然科学基金(81401231)
【分类号】：R726.1

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