实用医学杂志 ›› 2023, Vol. 39 ›› Issue (1): 66-70.doi: 10.3969/j.issn.1006⁃5725.2023.01.011

• 临床研究 • 上一篇    下一篇

意识指数对经鼻右美托咪定在婴幼儿超声心动图镇静深度的预测价值

黄雅莹 罗昊 黄俊祥 宋兴荣 谭永红 李碧莲   

  1. 广州医科大学附属广州市妇女儿童医疗中心麻醉与围术期科(广州 510120)

  • 出版日期:2023-01-10 发布日期:2023-01-10
  • 通讯作者: 李碧莲 E⁃mail: 13570226780@126.com
  • 基金资助:
    国家自然科学基金(编号:81901385)

Predictive value of consciousness index in sedation depth in infants and children with intranasal dexmedeto⁃ midine during echocardiography

HUANG Yaying,LUO Hao,HUANG Junxiang,SONG Xingrong,TAN Yong⁃ hong,LI Bilian.   

  1. Department of Anesthesiology,Guangzhou Women and Children′s Medical Center,Guangzhou Med⁃ ical University,Guangzhou 510120,China

  • Online:2023-01-10 Published:2023-01-10
  • Contact: LI Bilian E⁃mail:13570226780@126.com

摘要:

目的 探讨意识指数(index of consciousness,IoC)对不同剂量经鼻给予右美托咪定在婴幼儿 超声心动图检查中镇静深度的预测价值。方法 选择门诊镇静下行经胸超声心动图检查的非紫绀型先 天性心脏病患儿 254 例,分别经鼻给予右美托咪定 3 μg/kg(A 组)和 4 μg/kg(B 组)。并监测镇静前(T0)、 检查前(T1)、检查中(T2)、检查后(T3)、及出室时(T4)IoC 值。利用相关性分析及绘制 ROC 曲线的方式分 析 IoC、镇静评分、体动评分及行为评分对镇静深度的预测价值,计算 ROC 曲线下面积。结果 与 A 组比 较,B 组镇静成功率显著提高(P < 0.05);且 B 组 T1、T2、T3时间点的 IoC 值显著降低(P < 0.05)。IoC 值与镇 静评分呈显著负相关(r = -0.792,P < 0.01),与行为评分呈正相关(r = 0.429,P < 0.01)。ROC 分析显示,相 较于其他监测指标,IoC 对镇静深度具有更好的预测价值。结论 与镇静评分、行为评分相比,IoC 对婴幼 儿超声心动图检查的镇静深度有更好的预测价值。

关键词:

意识指数, 婴幼儿, 右美托咪定, 镇静深度 ,

Abstract:

Objective To investigate the value of index of consciousness (IoC in predicting the sedation depth in infants and children with different doses of intranasal dexmedetomidine during echocardiography. Methods A total of 254 children patients with non ⁃ cyanotic congenital heart disease undergoing transthoracic echocardiography were divided into group A(intranasal dexmedetomidine 3 μg/kg,n = 127)and group B(intranasal dexmedetomidine 4 μg/kg,n = 127). And IoC values were monitored before sedation(T0),before examination (T1),during examination(T2),after examination(T3),and when leaving the room(T4). Correlation analysis and receiver⁃operating characteristic(ROC)curve were used to analyze the predictive value of IoC,The University of Michigan Sedation Scale(UMSS)score,body movement score and behavior score for the sedation depth,and the area under the ROC curve was calculated. Results The sedation success rate in group B was significantly higher than that in group A(P < 0.05). The IoC value at T1,T2,T3 in group B was significantly lower than that in group A (P < 0.05). Correlation analysis showed that IoC value was negatively correlated with UMSS score(r = -0.792 P < 0.01),but positively with behavior score(r = 0.429,P < 0.01). ROC analysis showed that IoC had a better predictive value for sedation depth than other monitoring indicators. Conclusion Compared with sedation score and behavior score,IoC has better predictive value for the depth of sedation in infant and children echocardiography.

Key words:

index of consciousness, children, dexmedetomidine, depth of sedation