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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(P<0.05)。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。
Objective: To investigate the effect of different doses of etomidate on sedation depth in children under general anesthesia. Methods: Forty-four children undergoing orthopedic surgery 5 to 13 years old were randomly divided into four groups: group A, group B, group C and group D, with 11 patients in each group. The dose of etomidate was given to group A 200μg / kg, B group 300μg / kg, C group 400μg / kg, D group 500μg / kg. During the operation, BIS, NIBP, ECG, Sp O2 and HR were monitored in children with midazolam, remifentanil, etomidate Anesthesia induction was performed in the order of the ester and cisatracurium. Patients were recorded before anesthesia (T1), laryngoscopic exposure to the glottis (T2), intubation (T3), intubation end of 1 minute (T4), 5 minutes (T5), 10 minutes Frequency index (BIS), oxygen saturation (Sp O2), heart rate (HR), mean arterial pressure (MAP) values. Results: At the time points of T5 and T6, the BIS values in group A were significantly greater than those in the other three groups. At T3-T6, the BIS values in group D were significantly lower than those in groups A, B and C (P <0.05 ). Conclusion: Etomidate emulsion 300 ~ 400μg / kg for induction of general anesthesia in children, anesthesia depth better, no significant adverse reactions, can effectively inhibit the stress response.