脑电意识指数和伤害敏感指数监测在小儿扁桃体腺样体切除术中的应用价值分析

Application of Index of Consciousness 1 and Index of Consciousness 2 monitoring in pediatric tonsillectomy

目的探讨脑电意识指数(IoC1)和伤害敏感指数(IoC2)监测在小儿扁桃体腺样体切除术中的应用价值。方法选取2021年6月—2022年5月永康市第一人民医院收治的行扁桃体腺样体切除术患儿150例纳入此次研究,随机分为对照组和观察组,每组各75例。对照组患儿使用传统血流动力学指标进行麻醉监测,观察组患儿选择IoC1和IoC2监测。比较两组患儿术中血流动力学及术中和围术期情况,并比较两组患儿并发症发生率和疼痛程度。结果观察组患儿麻醉药物输注时间、拔管时间明显低于对照组(22.80±2.75 min vs.28.57±3.20 min,26.65±4.50 min vs.32.62±5.58 min),瑞芬太尼用量、药物输注速率调整次数明显高于对照组(698.25±86.53 mg vs.620.95±60.72 mg,12.16±1.32次vs.7.72±0.98次),差异有统计学意义(P<0.05),两组患儿丙泊酚用量差异无统计学意义(P>0.05)。各个时间点观察组患儿的HR、MAP明显低于对照组;且观察组患儿的呼吸恢复时间(22.72±4.02 min vs.28.65±4.57 min)、睁眼时间(52.93±4.72 min vs.68.50±5.62 min)、术后第1天及术后第2天的疼痛评分均低于对照组,同时观察组患儿不良反应发生率为4.00%,明显低于对照组13.33%的不良反应率,差异均有统计学意义(均P<0.05)。结论IoC1联合IoC2指导下的麻醉管理可给予患儿更精确麻醉,维持血流动力学稳定,促进患儿术后恢复并缓解术后疼痛,且降低并发症发生率。

Objective To investigate the impact of anesthesia management guided by the Index of Consciousness 1(IoC1)and Index of Consciousness 2(IoC2)on pediatric tonsillectomy.Methods 150 children who underwent tonsillectomy at the First People's Hospital of Yongkang City from June 2021 to May 2022 were selected and included in this study.They were randomly divided into a control group and an observation group,with 75 cases in each group.The control group of children used traditional hemodynamic indicators for anesthesia monitoring,while the observation group of children chose IoC1 and IoC2.Compare intraoperative hemodynamics and perioperative conditions between two groups of children,and compare the incidence of complications and pain levels between the two groups.Results The infusion time and extubation time of anesthetic drugs in the observation group were significantly lower than those in the control group(22.80±2.75 minutes vs.28.57±3.20 minutes,26.65±4.50 vs.32.62±5.58 min),and the dosage of remifentanil and the number of adjustment of drug infusion rate were significantly higher than those in the control group(698.25±86.53 mg vs.620.95±60.72 mg,12.16±1.32 times vs.7.72±0.98 times),the difference was statistically significant(P<0.05),There was no significant difference in the dosage of propofol between the two groups(P>0.05).At each time point,the HR and MAP of the observation group were significantly lower than those of the control group;Moreover,the respiratory recovery time(22.72±4.02 minutes vs.28.65±4.57 minutes),eye opening time(52.93±4.72 minutes vs.68.50±5.62 minutes),and pain scores on the first and second postoperative days in the observation group were lower than those in the control group.At the same time,the incidence of adverse reactions in the observation group was 4.00%,significantly lower than the 13.33%adverse reaction rate in the control group,and the differences were statistically significant(P<0.05).Conclusion Anesthesia management guided by IoC1 combined with IoC2 can provide children with more precise anesthesia,maintain hemodynamic stability,promote postoperative recovery and alleviate postoperative pain,and reduce the incidence of complications.