意识指数监测小儿吸入七氟醚麻醉深度的准确性:与BIS的比较

摘要

Objective To evaluate the accuracy of the index of consciousness (IoC) in monitoring the depth of anesthesia with sevoflurane inhalation in children,by comparing it with the bispectral index (BIS).Methods Forty-two ASA physical status Ⅰ or Ⅱ children,aged 8-12 yr,scheduled for elective abdominal surgery under general anesthesia,were studied.Anesthesia was induced with sevoflurane inhalation.The patients were endotracheally intubated.The concentration of sevoflurane was then adjusted to maintain the end-tidal concentration of sevoflurane (CETSev) at 1.6％,2.1％,2.6％,3.1％,3.6％,4.1％ and 4.6％ for5 min.The IoC and BIS values were recorded simultaneously.Results When CETSev ＜ 3.1％,CETSev was negatively correlated with IoC and BIS values,and the correlation coefficients between CETSev and IoC and BIS values were-0.927 (r1) and -0.869 (r2),respectively (P ＜ 0.01).When 3.1％ ≤ CETSev ≤ 4.6 ％,CET Sev was negatively correlated with IoC and BIS values,and the correlation coefficients between CETSev and IoC and BIS values were-0.808 (r3,P＜ 0.01) and-0.430 (r4,P ＜ 0.05),respectively.Comparison of the absolute value of correlation coefficients:there was no significant difference between r1,r2 and r3 (P ＞ 0.05) ; r1,r2 and r3 were significantly larger than r4 (P ＜ 0.01).Conclusion IoC can accurately reflect the depth of anesthesia with sevoflurane inhalation in children and when 3.1％ ≤ CET Sev ≤ 4.6 ％,the accuracy of IoC in monitoring the depth of anesthesia is superior to that of BIS.%目的 评价意识指数(IoC)监测小儿吸入七氟醚麻醉深度的准确性.方法 择期全麻下行腹部手术患儿42例,ASA分级Ⅰ级或Ⅱ级,性别不限,年龄8～ 12岁.吸入七氟醚麻醉诱导气管插管后,调节吸入七氟醚的浓度,分别维持呼气末七氟醚浓度(CET Sev) 1.6％、2.1％、2.6％、3.1％、3.6％、4.1％和4.6％5 min,同步记录IoC值和BIS值.结果 CET Sev＜ 3.1％时,其与IoC值、BIS值均呈负相关,相关系数分别为-0.927(r1)、-0.869 (r2)(P＜ 0.01)；CETSev 3.1％ ～ 4.6％时,其与IoC值、BIS值均呈负相关,相关系数分别-0.808(r3,P＜0.01)、-0.430 (r4,P＜0.05).相关系数绝对值比较:r1、r2及r3间比较差异无统计学意义(P＞0.05),r1、r2、r3均大于r4(P ＜0.01).结论 IoC能准确反映小儿吸入七氟醚的麻醉深度；CETSev 3.1％ ～ 4.6％时,IoC监测其麻醉深度的准确性优于BIS.