目标BIS监测下心理干预对小儿七氟醚全麻苏醒期躁动的临床观察.docVIP

精品论文 参考文献 目标BIS监测下心理干预对小儿七氟醚全麻苏醒期躁动的临床观察 詹剑1 李灵2 　　（1泸州医学院附属医院麻醉科 四川泸州 646000） 　　（2泸州医学院附属医院眼科 四川泸州 646000） 　　【摘要】 目的：探讨目标BIS监测下心理干预对小儿七氟醚全麻苏醒期躁动的影响。方法：48例4～10岁择期腹腔镜下行小儿疝气手术的患儿随机均分为两组。心理干预（M）组：麻醉医师术前访视沟通，术前家属陪护麻醉诱导及术后陪护复苏；对照（C）组：麻醉医师术前访视沟通。两组患儿术中目标BIS均维持在40～60。观察并记录小儿麻醉前(T1)、术中(T2)及苏醒后(T3)平均BIS、HR、SBP及术中七氟醚MAC值，并记录苏醒时间和术后躁动评分。结果：心理干预组麻醉前、术中及术后BIS、HR、SBP值，七氟醚MAC值及术后苏醒时间与对照组无明显差异(Pgt;0.05)；术后躁动发生率明显低于对照组(Plt;0.01)。结论：目标BIS监测下心理干预能够有效减少小儿七氟醚全麻苏醒期躁动的发生率。 　　【关键词】 小儿；全身麻醉；苏醒期躁动；心理干预；脑电双频指数 　　【中图分类号】R72 【文献标识码】A 【文章编号】1007-8231（2015）11-0014-03 　　【Abstract】Objective To discuss the clinical effects of psychological intervention on emergence agitation after sevoflurane anesthesia in children under target BIS monitoring. Methods Forty-eight children who were 4 to 10 years old for elective laparoscopic hernia surgery were randomly divided into two groups equally. group M: preoperative visit by an anesthesiologist, children accompanied by family?member?at the time of induction and recovery of general anaesthesia.group C: preoperative visit by an anesthesiologist.The target BIS of the two groups of children were maintained in the range of 40 to 60 during operation.The systolic blood pressure(SBP,) heart rate(HR),Bispectral index(BIS) were observed and recorded at pre-anesthesia(T1), intra-operative (T2), post-anaesthetic recovery period(T3). MAC of sevoflurane during operation, recovery time and postoperative agitation were recorded. Results There were no differences on BIS, SBP,HR( at T1 ,T2 and T3),MAC of sevoflurane during operation and recovery time of two groups(Pgt;0.05).But the incidence of postoperative agitation of group M was significantly lower than control group(Plt;0.01).Conclusion The psychological intervention can effectively reduce the emergence agitation after sevoflurane anesthesia in children under target BIS monitoring. 　　【Key words】Children;general anesthesia;Emergence agitation; Psychological intervention; Bispe