Impact of Bispectral Index for monitoring propofol remifentanil anaesthesia. A randomised clinical trial
Impact of Bispectral Index for monitoring propofol remifentanil anaesthesia. A randomised clinical trial
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DOI：
10.1111/aas.12158
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发表时间：
2013-09-01
影响因子：
2.1
通讯作者：
Lambert, P. H.
中科院分区：
文献类型：
--
作者：
Bresil, P.;Nielsson, M. S.;Lambert, P. H.
背景：先前的研究表明，使用脑电双频指数（BIS）监测仪测量麻醉深度可以减少麻醉药的用量和全身麻醉的恢复时间。尚未研究 BIS 对接受异丙酚和瑞芬太尼全静脉麻醉 (TIVA) 的儿科人群的麻醉恢复和麻醉药消耗的影响。方法：单盲、单中心临床试验。共有一百五十七名患者入组。他们被安排进行耳鼻喉手术，并根据年龄组（1-3岁、4-11岁、12-17岁、18-65岁）和手术类型进行分层，总共产生九个亚组。根据常规临床实践（对照）或 BIS 指导，患者被随机分配接受异丙酚和瑞芬太尼 TIVA 治疗。以标准化异丙酚（g/kg/min）和瑞芬太尼（g/kg/min）消耗量以及拔管时间为结果指标。 结果：与对照组相比，BIS 组 1-3 岁儿童的拔管时间更长（P：0.04）。与对照组相比，BIS 组 12-17 岁患者接受丙泊酚维持输注率较高（P=0.02）。其他年龄组的结果变量没有显着差异。 结论：与传统做法相比，用于指导异丙酚-瑞芬太尼麻醉的 BIS 监测不会减少成人和儿童的麻醉药消耗量，也不会减少拔管时间。 （ClinicalTrials.gov 标识符：NCT01043952；http://clinicaltrials.gov/ct2/show/NCT01043952）
Background: Previous research has shown that the use of the bispectral index (BIS) monitor to measure the depth of anaesthesia reduces the amount of anaesthetics administered and the recovery time from general anaesthesia. The effect of BIS on recovery from anaesthesia and consumption of anaesthetics in a paediatric population receiving total intravenous anaesthesia (TIVA) with propofol and remifentanil has not been studied.Methods: A single-blind, single-centre clinical trial. One hundred fifty-seven patients were enrolled. They were scheduled for ear, nose, and throat surgery and stratified according to age groups (1-3 years, 4-11 years, 12-17 years, 18-65 years) and type of operation, yielding a total of nine subgroups. Patients were randomly allocated to receive either a TIVA with propofol and remifentanil according to conventional clinical practice (control) or guided by BIS. Normalised propofol (g/kg/min) and remifentanil (g/kg/min) consumption and time to extubation (s) were the outcome measures.Results: Children aged 1-3 years in the BIS group had a longer time to extubation compared with controls (P: 0.04). Patients aged 12-17 years in the BIS group received higher maintenance infusion rates of propofol compared with controls (P=0.02). No significant difference for the outcome variables was evidenced in the other age groups.Conclusion: BIS monitoring for guidance of propofol-remifentanil anaesthesia does not result in reduced consumption of anaesthetics and does not reduce time to extubation in adult and children compared with conventional practice. (Clinicaltrials.gov identifier: NCT01043952; http://clinicaltrials.gov/ct2/show/NCT01043952)