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BIS监测引导麻醉对儿童术后恶心呕吐发生率的影响:一项前瞻性随机双盲研究
贵州医科大学 麻醉与心脏电生理课题组
翻译：严旭 编辑：田明德 审校：曹莹
背景：术后恶心呕吐（PONV）是儿童手术后常见的问题，而挥发性麻醉剂是导致该现象的重要因素。BIS监测引导的麻醉通过减少麻醉药物的使用量，在成人患者中可降低PONV的发生率。
研究目的：评估BIS监测引导麻醉在降低儿童术后恶心呕吐发生率中的作用。
研究设计：前瞻性、随机、双盲研究。
研究地点：单中心研究，地点为捷克共和国的一所大学医院，研究时间为2021年6月至2022年11月。
研究对象：共纳入163名年龄3至8岁、ASA I-II级、接受全身麻醉下内镜腺样体切除术的儿童。
干预措施：在干预组中，通过BIS监测将麻醉深度维持在40至60之间。
主要结局指标：主要结局指标为术后24小时内恶心和呕吐的发生率。
结果：与对照组相比，BIS监测引导麻醉显著降低了恶心和呕吐的发生率 [17% vs. 53%；RR（95% CI）0.48（0.27-0.86）；P < 0.001和16% vs. 34%；RR（95% CI）0.33（0.20-0.54）；P = 0.01，分别为恶心和呕吐发生率]。
结论：BIS监测引导的麻醉可降低接受腺样体切除术儿童的术后恶心呕吐发生率。
原始文献来源：Frelich M, Sklienka P, Romanová T, et,al. The effect of BIS-guided anaesthesia on the incidence of postoperative nausea and vomiting in children: a prospective randomized double-blind study[J]. BMC Anesthesiol, 2024 Jul 9;24(1):228. doi: 10.1186/s12871-024-02610-w.
The effect of BIS-guided anaesthesia on the incidence of postoperative nausea and vomiting in children: a prospective randomized double-blind study
Abstract
Background: Postoperative nausea and vomiting (PONV) is a significant problem following paediatric surgery, and volatile anaesthetics are an important cause of this phenomenon. BIS-guided anaesthesia, by reducing the consumption of anaesthetics, leads to a decrease in PONV in adult patients.
Study objective: Evaluate the role of BIS-guided anaesthesia in reducing the incidence of paediatric PONV.
Design: Prospective, randomized, double-blind study.
Setting: A single center study in university hospital in Czech republic, from June 2021 to November 2022.
Patients: A total of 163 children, aged 3-8 years with ASA I-II who underwent endoscopic adenoidectomy under general anaesthesia were included.
Interventions: In the intervention group, the depth of anaesthesia was maintained to values between 40 and 60 of BIS.
Main outcome measure: The primary outcome was the incidence of postoperative nausea and vomiting during 24 h after surgery.
Results: The use of BIS-guided anaesthesia led to a significant decrease in the incidence of nausea and vomiting compared to the control group [17% vs. 53%; RR (95%CI) 0.48 (0.27-0.86); p < 0.001and 16% vs. 34%; RR (95%CI) 0.33 (0.20-0.54); p = 0.01, respectively.
Conclusions: BIS-guided anaesthesia decreases the incidence of postoperative nausea and vomiting in children undergoing adenoidectomy.
