Pediatric evaluation of the bispectral index (BIS) monitor and correlation of BIS with end-tidal sevoflurane concentration in infants and children
Pediatric evaluation of the bispectral index (BIS) monitor and correlation of BIS with end-tidal sevoflurane concentration in infants and children
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DOI：
10.1213/00000539-200004000-00018
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发表时间：
2000-04-01
影响因子：
5.7
通讯作者：
Rosow, CE
中科院分区：
文献类型：
--
作者：
Denman, WT;Swanson, EL;Rosow, CE
脑电双频指数（BLS）已在成人中得到发展，并与麻醉药的临床催眠作用密切相关。我们调查了BIS是否反映了催眠的临床标志物，并证明了婴儿和儿童的药物剂量反应性。在本研究的观察组中，观察了接受全身麻醉的儿童的BIS值，并与先前在成人研究中收集的类似数据进行了比较。在研究的第二组中，给予一系列稳态潮气末浓度的七氟烷，并记录相应的BIS。研究了婴儿（0-2 vr）和儿童（2-12岁）之间的差异。与成人相比，儿童在诱导前、维持期间和苏醒时的BIS值无差异。在相似的临床麻醉水平下，婴儿和儿童的BIS没有差异。在儿童和婴儿中，BIS与七氟烷的潮气末浓度成正比。BIS = 50时的七氟烷浓度（95%置信区间）存在显著差异：婴儿为1.55%（1.40-1.70），儿童为1.25%（1.12-1.37）。虽然无法用特定的行为终点进行验证，但BIS与儿童麻醉的临床指标相关，就像在成人中一样：随着麻醉深度的增加，BIS减少。BIS与婴儿和儿童的七氟烷浓度相关。婴儿和儿童之间的浓度-反应差异与数据一致，表明1岁以下儿童的最小肺泡浓度较高。意义：在全身麻醉期间使用脑电双频指数（sis）可改善成人麻醉药的滴定。本研究的数据提示，同样的脑电图分析设备和方法可以应用于婴儿和儿童。
The bispectral index: (BLS) has been det eloped in adults and correlates well with clinical hypnotic effects of anesthetics. We investigated whether BIS reflects clinical markers of hypnosis and demonstrates agent dose-responsiveness in infants and children. Sn an observational arm of this study, BIS values in children undergoing general anesthesia were observed and compared with similar data collected previously in a study of adults. In a second arm of the study, a range of steady-state end-tidal concentrations of sevoflurane was administered and corresponding BIS documented. Data were examined for differences between infants (0-2 vr) and children (2-12 yr). No difference was seen in BIS values in children before induction, during maintenance, and on emergence compared with adult values. There was no difference in BIS between infants and children at similar clinical levels of anesthesia. In children and infants, BIS was inversely proportional to the end-tidal concentration of sevoflurane. The sevoflurane concentration for a BIS = 50 (95% confidence interval) was significantly different: 1.55% (1.40-1.70) for infants versus 1.25% (1.12-1.37) for children. Although validation with specific behavioral end points was not possible, BIS correlated with clinical indicators of anesthesia in children as it did in adults: as depth of anesthesia increased, BIS diminished. BIS correlated with sevoflurane concentration in infants and children. The concentration-response difference between infants and children was consistent with data showing that minimum alveolar concentration is higher in children less than 1 yr of age. Implications: The use of bispectral index (sis) during general anesthesia improves the titration of anesthetics in adults. The data from this study suggest that the same equipment and method of electroencephalogram analysis may he applied to infants and children.