依托咪酯诱导小儿全身麻醉的剂量与镇静深度的相关性分析

目的:探究不同剂量依托咪酯诱导小儿全身麻醉时对镇静深度的影响。方法:选取5~13岁准备静脉麻醉行骨科手术的小儿44例,随机分为A组、B组、C组和D组四组,每组11例,分别给予依托咪酯的剂量为A组200μg/kg,B组300μg/kg,C组400μg/kg,D组500μg/kg。手术过程中监测患儿脑电双频指数(BIS)、血压(NIBP)、心电图(ECG)、血氧饱合度(Sp O2)、心率(HR),按照咪唑安定、瑞芬太尼、依托咪酯和顺式阿曲库铵的顺序进行麻醉诱导。分别记录患者麻醉前(T1)、喉镜暴露声门时(T2)、插管时(T3)、插管结束1分钟(T4)、5分钟(T5)、10分钟(T6)的脑电双频指数(BIS)、血氧饱合度(Sp O2)、心率(HR)、平均动脉压(MAP)的数值。结果:T5和T6两个时间点,A组的BIS值显著大于其他三组;T3-T6时,D组的BIS值显著小于A、B、C三组,差异有统计学意义(P0.05)。结论:依托咪酯乳剂300~400μg/kg用于小儿全麻诱导,麻醉深度效果较好,无明显的不良反应,可有效抑制应激反应。

The Correlation Analysis between the Dosage of Etomidate and Sedation in Anesthesia Induction of Children

Objective:To explore the impact of different dosage of etomidate and sedation in anesthesia induction of children.Methods:Forty-four children (5~13 years old) were involved and randomly assigned to 4 groups according to the dose of etomidate they received: group A (200 ug/kg), group B (300 ug/kg), group C (400 ug/kg), group D (500 ug/kg). BIS, NIBP, ECG, SpO2 and HR were monitored during the surgery. Midazolam, remifentanil, etomidate and cisatracurium were used sequentially. The value of BIS, SpO2, HR and MAP were recorded before anesthesia(T1), when the glottis was exposed by laryngoscope(T2), during intubation(T3), in one minute (T4), five minute (T5), ten minute (T6) after intubation.Results:In time points of T5-T6, the value of BIS in group A was sig- nificantly higher than that in other three groups; in time points of T3-T6, the value of BIS in group D was significantly lower than that in A, B and C groups(P<0.05).Conclusion:Etomidate 300~400 ug/kg can bring adequate depth of sedation in children. No significant adverse reactions. Inhibiting the stress response effectively.