脑电双频指数及麻醉趋势指数在学龄前儿童腹腔镜手术中的变化

Changes of the narcotrend index and bispectral index in preschool chil-dren in laparoscopic surgery

目的 比较脑电双频指数（BIS）与麻醉趋势指数（NTI）在学龄前儿童腹腔镜手术中的差异,为进一步研究小儿麻醉深度监测提供临床数据.方法 选择2014年4～10月深圳市儿童医院腹腔镜手术患儿76例,随机分为NTI组（26例）、BIS组（26例）和对照组（24例）.记录术中不同时间点及意识恢复过程BIS与NTI的变化情况;记录三组患儿手术时长、停药至自主呼吸恢复时间和术中七氟烷用量.结果 BIS组与NTI组手术时间比较差异无统计学意义（P＞0.05）,但均比对照组短（P＜ 0.05）;NTI组停药至自主呼吸恢复时间和七氟烷醚用量均比BIS组和对照组少（P＜0.01）;诱导前期、气腹消除和拔除气管导管时NT值与BIS值比较,差异有统计学意义（P＜0.05或P＜ 0.01）;意识恢复情况比较中,小孩恢复定向力时NTI值比BIS值高（P＜0.01）.结论 NTI与BIS均能监测儿童的麻醉深度,但NTI在较深麻醉状态时呈下降趋缓,而苏醒期回升速度较快,反映恢复质量性能NTI略优于BIS.

Objective To Compare the different between bispectral index （BIS） and narcotrend index （NTI） in preschool children during laparoscopic operation,in order to provide clinical data in further research with pediatric anesthesia depth monitoring.Methods 76 children from April to October 2014 treated with laparoscopic surgery in Children Hospital of Shenzhen,were choosen and divided into three groups randomly,narcotrend group （26 cases）,BIS （26 cases） and control group （24 cases）.The BIS and NTI were recorded in different time and consciousness recovery process;surgical time,drug withdrawal to spontaneous breathing recovery time and the dosage of intraoperative sevoflurane of children in three groups were also recorded.Results There was no statistically significant difference between BIS and NT group in operating time （P ＞ 0.05）,but they were shorter than that of the control group （P ＜ 0.05）;NT group of drug withdrawal to spontaneous breathing recovery time and dosage of sevoflurane ether were less than those of the BIS group and the control group （P ＜ 0.05）;the NTI and BIS at the early stage of the induced,pneumoperitoneum elimination and removing the endotracheal tube had statistically significant differences （P ＜ 0.05 or P ＜ 0.01）;the NT value in directional force to restore was higher than the BIS value in the consciousness recovery comparison （P ＜ 0.01）.Conclusion Both NT and the BIS can monitor the children anesthesia depth indicator,but NT in deep anesthesia decrease to slow,and revival period picks up speed faster,reflect the quality of recovery performance NT slightly better than the BIS.