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目的探讨脑电双频指数(BIS)与麻醉意识深度指数(CSI)变化在小儿七氟醚麻醉深度监测的应用价值。方法择期全麻下行眼科手术小儿患者26例,年龄3～12岁,ASAⅠ～Ⅱ级。七氟醚吸入诱导,插入可弯喉罩,术中间歇正压通气(IPPV),吸入七氟醚,静脉泵注0.1～0.2μg/(kg·min)瑞芬太尼,间断追加维库溴铵维持肌松。记录麻醉诱导前(T0)、诱导后(T1)、插入喉罩后即刻(T2)、呼末七氟醚浓度1%(T3)、1.5%(T4)、2%(T5)、2.5%(T6)及苏醒时(T7)的HR、BP、BIS、CSI值。结果与T0相比,T1、T2时BIS、CSI、MAP均显著降低(P<0.05),而HR无明显变化。T1、T2时CSI显著高于同时点的BIS值(P<0.05)。术中BIS和CSI随七氟醚浓度增加而明显降低(P<0.05),与七氟醚spearman等级相关系数r分别为-0.93、-0.90(P<0.01),而MAP、HR相关系数为-0.56、-0.42。T7时CSI值显著高于BIS值(P<0.05)。结论随七氟醚浓度增加,小儿的BIS与CSI值均逐渐降低,与七氟醚浓度呈显著负相关。与BIS相比,CSI在深麻醉时数值下降趋缓,而苏醒期回升速度较快。两者性能均优于HR和BP。
Objective To explore the value of bispectral index (BIS) and anesthetic depth of consciousness (CSI) in monitoring the depth of sevoflurane anesthesia in children. Methods Twenty-six pediatric patients undergoing ophthalmic surgery under elective anesthesia were aged 3 to 12 years old with ASA grade Ⅰ ~ Ⅱ. Induction of sevoflurane induction, insertion of flexible laryngeal mask, intraoperative intermittent positive pressure ventilation (IPPV), inhalation of sevoflurane, intravenous injection of 0.1 ~ 0.2μg / (kg · min) remifentanil, intermittent addition of vecuronium Ammonia to maintain muscle relaxation. (T0), post-induction (T1), immediately after insertion of laryngeal mask (T2), 1% T6) and awake (T7) HR, BP, BIS, CSI values. Results Compared with T0, BIS, CSI and MAP were significantly decreased at T1 and T2 (P <0.05), while HR had no significant change. The CSI at T1 and T2 was significantly higher than that at the same time point (P <0.05). The intraoperative BIS and CSI were significantly decreased with the increase of sevoflurane concentration (P <0.05), and the correlation coefficients of spearman level with sevoflurane r were -0.93 and -0.90, respectively (P <0.01) 0.56, -0.42. The CSI value at T7 was significantly higher than the BIS value (P <0.05). Conclusions With the increase of sevoflurane concentration, BIS and CSI values in children decrease gradually and have a significant negative correlation with sevoflurane concentration. Compared with BIS, CSI slowed down during deep anesthesia, while the recovery period recovered faster. Both are better than HR and BP.