rSO_(2)-BIS-多模式麻醉管理对儿童全身麻醉术后不良行为的影响

Effect of rSO_(2)-BIS-Based Multi-Mode Anesthesia Management on Postoperative Adverse Behaviors in Children Undergoing General Anesthesia

目的探讨局部脑氧饱和度(rSO_(2))-脑电双频谱指数(BIS)-多模式麻醉管理对儿童全身麻醉术后不良行为的影响。方法选取医院2019年1月至2020年6月收治的行单侧腹股沟斜疝手术患儿188例,按随机数字表法分为观察组和对照组,各94例。全身麻醉后观察组患儿予rSO_(2)-BIS-多模式麻醉管理,对照组患儿予常规麻醉管理。结果观察组患儿血浆、异丙酚、胶体液的用量均显著少于对照组(P<0.05),术后不良行为发生率显著高于对照组(P<0.05),镇痛药补救率显著低于对照组(P<0.05);且术后行为改变中整体焦虑、分离焦虑、睡眠焦虑、饮食障碍、攻击性、冷漠退缩发生率均显著低于对照组(P<0.05);多因素分析结果显示,异丙酚用量是影响儿童全身麻醉术后不良行为的独立危险因素,多模式麻醉管理是影响儿童全身麻醉术后不良行为的保护因素(P<0.05)。结论全身麻醉后予rSO_(2)-BIS-多模式麻醉管理能在一定程度上改善患儿的手术效果,降低患儿术后不良行为的发生率。

Objective To investigate the effect of regional cerebral oxygen saturation(rSO_(2))-bispectral index(BIS)-based multi-modal anesthesia management on postoperative adverse behaviors in children undergoning general anesthesia.Methods A total of 188 children scheduled for unilateral indirect inguinal hernia surgery in our hospital from January 2019 to June 2020 were selected and divided into the observation group and the control group according to the random number method,94 cases in each group.After general anesthesia,the children in the observation group were given rSO_(2)-BIS-based multi-modal anesthesia management,while the children in the control group were given routine anesthesia management.Results The dosage of plasma,propofol and colloidal fluid in the observation group was significantly lower than that in the control group(P<0.05),the incidence rate of postoperative adverse behavior was significantly higher than that in the control group(P<0.05),and the rescue rate of analgesic drugs was significantly lower than that in the control group(P<0.05).The incidence rates of overall anxiety,separation anxiety,sleep anxiety,eating disorder,aggression,apathy and withdrawal in postoperative behavior changes were significantly lower than those in the control group(P<0.05).The results of multivariate analysis showed that the dosage of propofol was an independent risk factor affecting postoperative adverse behaviors in children underwent general anesthesia,and multi-modal anesthesia management was a protective factor affecting postoperative adverse behaviors in children underwent general anesthesia(P<0.05).Conclusion After general anesthesia in children,the rSO_(2)-BIS-based multi-modal anesthesia management can improve the surgical effect of children to a certain extent,and reduce the incidence of postoperative adverse behaviors in children.