七氟烷不同吸入深度在小儿全麻诱导中的应用

Application of endtidal concentration of sevoflurane during the inhalational induction of anesthesia in children

目的探讨七氟烷不同吸入浓度在小儿全麻诱导过程中静脉穿刺及脑电双频指数(BIS)的相关性。方法全麻患儿90例,均为ASAⅠ级,根据呼气末七氟烷浓度随机分为A组(2MAC,30例),B组(2.5MAC,30例),C组(3MAC,30例)。观察三组患儿麻醉诱导时的BIS值及静脉穿刺时体动反应。结果三组患儿静脉穿刺时体动反应发生率差异具有显著性(P<0.05),C组最低。三组患儿吸入七氟烷诱导深度与BIS有相关性(r=-0.954 9,P<0.000 1),但在C组观察到呼气末七氟烷浓度达到2.7MAC时BIS值存在一过性升高。结论呼气末七氟烷浓度达到3MAC时最宜静脉穿刺,且在七氟烷吸入诱导的整个过程中其与BIS有相关性。BIS与小儿七氟烷全麻诱导深度之间存在负相关。

Objectlve To explore the assoclatlon of endtldal concentratlons of sevoflurane wlth the lntravenous cannulatlon and the blspectral lndex（ BlS） durlng the lnhalatlonal lnductlon of anesthesla ln chlldren（ ASA Ⅰ）.Methods Nlnety chlldren undergolng electlve surgery were randomly allocated lnto group A（ 2MAC,n = 30）,group B（ 2.5MAC,n = 30） and group C（ 3MAC,n = 30） accordlng to the endtldal concentratlon of sevoflurane.BlS and patlent movements lnduced by lntravenous cannulatlon were recorded durlng the lnhalatlonal lnductlon of anesthesla ln three groups.Results There was a slgnlflcant dlfference ln the lncldence of patlent movements durlng lnhalatlonal lnductlon of anesthesla among three groups（ P 〈0.05）,and lt was the lowest ln group C.BlS was negatlvely assoclated wlth the endtldal concentratlons of sevoflurane durlng the lnhalatlonal lnductlon of anesthesla ln three groups（ r =-0.954 9,P 〈0.000 1）.However,there was a translent lncrease of BlS ln group C when the endtldal concentratlon of sevoflurane reached 2.7MAC.Concluslon The results suggest that lntravenous cannulatlon should be performed when the endtldal concentratlon of sevoflurane reaches 3MAC.BlS ls negatlvely assoclated wlth the endtldal concentratlon of sevoflurane durlng the lnhalatlonal lnductlon of anesthesla ln chlldren.