Narcotrend在静吸复合全麻减浅期镇静深度监测的应用(1)
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[摘要] 目的 评价Narcotrend(NT)在全麻减浅期镇静深度监测效能。方法 选择60例择期手术患者，随机分为两组。关腹膜时或骨科内固定完成时停止吸入麻醉，洗肺到NT指数(NI)维持C级2min时，开始靶控输注异丙酚浓度2mg/L。Ⅰ组根据基本的生命体征调节吸入七氟烷浓度到手术结束；Ⅱ组调节吸入七氟烷浓度使肺泡呼气末浓度维持在(0.6±0.1)MAC到手术结束。观察两组NI、平均动脉压(MAP)、心率(HR)变化，比较两组内和组间NI，记录和比较两组术后PACU期间各种恢复情况。结果 两组靶控3min的NI与基础值比较均有统计学差异(P<0.05)，Ⅱ组麻醉恢复比Ⅰ组满意。结论 Narcotrend监测能客观反映全麻减浅期患者镇静深度变化。
[关键词] Narcotrend；减浅期；镇静；深度监测；异丙酚；七氟烷
[中图分类号] R614.2+1 [文献标识码] B [文章编号] 1673-9701(2011)31-92-03
Application of Narcotrend-assisted Depth of Sedation Monitor during Lightening from Inhalation-intravenous Balanced Anesthesia
WU Tianliang HAN Ying YU Guocan
Department of Anesthesiology，Fuyang People’s Hospital in Zhejiang Province，Fuyang 311400，China
[Abstract] Objective To assess the effect of Narcotrend-assisted on sedation depth monitoring during lightening from inhalation-Intravenous balanced anesthesia. Methods Sixty patients undergoing elective surgical procedures under general anesthesia were enrolled in the study. They were randomly divided into two groups. When peritoneum was closing or orthopedic fixation was completed，sevoflurane was discontinued and fresh gas flow was increased to make NI maintain at C level for 2 min，then anesthesia was administered with target-controlled infusion(TCI)of propofol with target plasma concentration(Ce)of 2 mg/L，in groupⅠsevoflurane was adjusted in accordance with basic vital signs，in groupⅡ sevoflurane was adjusted to achieve an end-tidal concentration level of(0.6±0.1)MAC until the end of surgery. The followings were recorded and compared NI，Mean arterial pressure and Heart rate. Recovery quality were recorded and compared between two group. Results In two group the Narcotrend target-controlled NI were lower at 3 min than those before TCI(P<0.05). They were found better recovery quality in group Ⅱ than in groupⅠ(P<0.05). Conclusion Narcotrend monitor can be used for predicting the depth of sedation objectively during lightening from inhalation-Intravenous balanced anesthesia ......
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