上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (12): 1650-.doi: 10.3969/j.issn.1674-8115.2017.12.012

• 论著（临床研究） • 上一篇    下一篇

依托咪酯用量对左向右分流先天性心脏病患儿血流动力学及脑电双频指数的影响

王春，朱昌娥，章赛吉，韩文栋，魏嵘   

  1. 上海市儿童医院  上海交通大学附属儿童医院麻醉科，上海  200062
  • 出版日期:2017-12-28 发布日期:2018-01-10
  • 通讯作者: 魏嵘，电子信箱：weir@shchildren.com.cn
  • 作者简介:?王春（1975 —），女，主治医师，学士；电子信箱：spring_anesthesia@163.com
  • 基金资助:
    上海交通大学医学院科技基金（12XJ10074）

Correlation of etomidate and bispectral index in anesthesia induction of children with congenital heart disease shunting from left to right#br#

WANG Chun, ZHU Chang-e, ZHANG Sai-ji, HAN Wen-dong, WEI Rong   

  1. Department of Anesthesiology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
  • Online:2017-12-28 Published:2018-01-10
  • Supported by:
    Science and Technology Fund of Shanghai Jiao Tong University  School of Medicine, 12XJ10074

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摘要： 目的 · 分析左向右分流先天性心脏病患儿连续泵注依托咪酯镇静时剂量与脑电双频指数（BIS）的相关性。方法 · 24 例左向 右分流先天性心脏病患儿全身麻醉诱导后停止吸入七氟醚，使 BIS 值逐渐恢复至 80；经外周静脉按 0.3 mg/（kg · min）剂量持续泵注 依托咪酯，待 BIS 值为 40 时停止泵入；记录期间 BIS 为 80、70、60、50 和 40 时心率（HR）、动脉压（ABP）和中心静脉压（CVP） 的变化及依托咪酯总的用量，分析左向右分流先天性心脏病患儿连续泵注依托咪酯镇静时剂量与 BIS 的相关性。结果 · 依托咪酯持续 泵注至 BIS 值达到 40 时，患儿血流动力学变化不明显，依托咪酯与 BIS 值呈负相关（r=-0.769，P<0.01）； 2 岁以下先天性心脏病患 儿依托咪酯平均剂量高于 2 岁以上先天性心脏病患儿 (P=0.034)。结论 · 依托咪酯对左向右分流先天性心脏病患儿血流动力学的影响较 小，泵注剂量与 BIS 值呈负相关；左向右分流先天性心脏病患儿 BIS 与年龄可能有一定关系。

关键词: 依托咪酯, 脑电双频指数, 先天性心脏病, 小儿

Abstract:

Objective · To explore the correlation of etomidate dose and bispectral index (BIS) in children with congenital heart disease shunting from left to right during anesthesia induction.  Methods · After general anesthesia induction to 24 children with congenital heart disease shunting from left to right, sevoflurane inhaling was stopped in order to make the BIS value gradually return to 80. Intravenous injection of etomidate was sustained by 0.3 mg/(kg·min) until the BIS value reached 40. The heart rate (HR), arterial blood pressure (ABP) and central venous pressure (CVP) of the patients were recorded when BIS value was 80, 70, 60, 50， and 40, respectively.The correlation of etomidate dose and BIS value in the children during anesthesia induction was analyzed.  Results · There were no significant hemodynamic changes when the BIS value  were from 80 to 40. The amount of etomidate was highly negatively correlated with the BIS value (r=-0.769, P<0.01), the average dose of etomidate in children under 2 years of age was significantly higher than that in children over 2 years old (P=0.034).  Conclusion · The etomidate dose is highly negatively correlated with the BIS value. Etomidate has less influence on hemodynamic parameters of children with congenital heart disease shunting from left to right. The BIS value may have relationship with patients’ age.

Key words: etomidate, bispectral index, congenital heart disease, children