39例七氟烷对发绀型和非发绀型先天性心脏病患儿诱导期脑电双频指数的影响

Effect of sevoflurane on the BIS for the infants with cyanotic and non-cyanotic congenital heart disease during induction of anesthesia

目的:对比吸入相同浓度七氟烷对发绀型及非发绀型先天性心脏病(先心病)患儿在诱导期不同时间点脑电双频指数(BIS)值的影响。方法:选择先心病患儿39例,其中发绀组19例(C组),非发绀组20例(NC组)。应用8%七氟烷诱导进入麻醉状态,记录维持七氟烷呼末浓度1.5MAC 5 min(T1)、10 min(T2)、气管插管后5 min(T3)和10 min(T4)的BIS值、平均动脉压(MAP)值和心率(HR)值。结果:发绀组T1点BIS值明显高于T2、T3、T4各点(P<0.05),非发绀组T1、T2、T3及T4各点BIS值比较差异无统计学意义。发绀组T1点BIS值明显高于非发绀组(P<0.05),而T2、T3、T4各点2组间BIS值差异无统计学意义。MAP值和HR值在组间和组内各点比较差异均无统计学意义。结论:麻醉诱导维持七氟烷呼末浓度1.5MAC,发绀型与非发绀型先心病患儿BIS值均能维持在适当的麻醉深度,但发绀型先心病患儿加深麻醉达到相同BIS值的时间较非发绀型患儿延迟。

Objective：To observe the effect of sevoflurane on the bispectral index（BIS） of infants with cyanotic and non-cyanotic congenital heart disease during induction of anesthesia.Methods：Thirty-nine infants including 19 cyanotic（group C） and 20 non-cyanotic congenital heart disease（group NC） were recruited.8% sevoflurane were used for anesthetic induction of all cases,and the concentration of end-respired sevoflurane was maintained 1.5 MAC.The BIS value was recorded at the following time points： 5 min（T1） and 10 min（T2） during the concentration of end-respired sevoflurane was 1.5MAC,5 min（T3） and 10 min（T4） after trachea intubation.Results： In cyanotic group,the BIS value at T1 was higher than that of T2,T3,T4 significantly（P0.05）,while in non-cyanotic group,there was no significant difference among every time point.The BIS at T1 was significant higher in cyanotic group than that in non-cyanotic group,while the BIS at T2,T3 and T4 between two groups had no significant differences.Conclusion： The BIS can be maintained properly in cyanotic and non-cyanotic group with 1.5MAC of end-respired sevoflurane for anesthetic induction.Comparing with non-cyanotic group,the time achieving the same BIS value during anesthetic induction is longer in cyanotic group.