体位对静脉全身麻醉患者Narcotrend指数的影响(1)
【摘要】 目的：观察体位对Narcotrend指数的影响。方法：选择2013年7-12月择期静脉全身麻醉手术患者45例，年龄20～60岁，男24例，女21例，体重指数17～23 kg/m2，ASAⅠ～Ⅱ级。平卧位靶控输注(TCI)异丙酚和瑞芬太尼麻醉诱导并维持麻醉，达到稳态靶浓度后5 min时，将患者置于头低脚高位(300)，维持约10 min；将患者调至平卧位10 min后，再将患者置于头高脚低高位(300)，维持约10 min。分别记录头低脚高位前(T0)、头低脚高位即刻(T1)、1 min(T2)、3 min(T3)、5 min(T4)和10 min(T5)以及头高脚低位即刻(T1)、1 min(T2)、3 min(T3)、5 min(T4)和10 min(T5)各时点的Narcotrend指数(NI)、平均动脉压(MAP)、心率(HR)、呼气末二氧化碳分压(PETCO2)。结果：与平卧位(T0)比较，患者头低脚高位时T2～5 MAP、T2～4 NI升高，头高脚低位时T2～5 MAP、T2～4 NI降低，差异有统计学意义(P<0.05)；与头低脚高位相同时点比较，患者头高脚低位时T2～5 MAP、T2～4 NI明显降低，差异有统计学意义(P<0.01)。结论：体位可影响静脉全身麻醉患者Narcotrend指数，影响麻醉医师对患者麻醉深度的判断。
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【关键词】 体位； Narcotrend指数； 静脉全麻
【Abstract】 Objective：To prospectively evaluate the effects of body position to the narcotrend index during intravenous anaesthesia.Method： 45 elective surgery patients aged from 20 to 60 years were selected in our hospital from July 2013 to December 2013，whom were 24 males and 21 females，with the BMI 17-23 kg/m2 and ASAI-Ⅱ level， the intravenous general anesthesia were underwent. Propofol and remifentanil anesthesia protocol was introduced and maintained with Target-controlled infusion(TCI) in supine position.5 min after reaching steady-state target concentration，the patients were changed in Trendelenburg position(30 degrees) and maintained about 10 min；10 min later，the position into anti-trendelenburg position were changed (30 degrees)，also maintained about 10 min. Narcotrend Index (NI)， mean arterial pressure (MAP)， heart rate (HR)， end-tidal carbon dioxide partial pressure (PETCO2) were recorded separately at the time points of before trendelenburg position(T0)，immediately(T1)，1 min (T2) later， 3 min(T3) later，5 min(T4) later and 10 min(T5) later after in Trendelenburg position and anti-trendelenburg position.Result：Compared the parameters in supine position(T0)，patients’ MAP in Trendelenburg position at the time point of T2-5 increased，also the NI at the time piont of T2-4 ，the difference was statistically significant (P<0.05).While， they were decreased in anti-trendelenburg position..The MAP at the point of T2-5，NI at the point of T2-4 were significantly lower in Trendelenburg position than in anti-trendelenburg position，the difference was statistically significant (P<0.01).Conclusion：Patients’ body position during intravenous anaesthesia can affect the Narcotrend index， of which will affect the anesthesiologists to judgment patients’ anesthesia depth.
【Key words】 Position； Narcotrend index； Intravenous anaesthesia
First-author’s address：Xiaolan Affiliated Hospital of Southern Medical University，Zhongshan 528415，China, 百拇医药(杨纲华等)
, http://www.100md.com
【关键词】 体位； Narcotrend指数； 静脉全麻
【Abstract】 Objective：To prospectively evaluate the effects of body position to the narcotrend index during intravenous anaesthesia.Method： 45 elective surgery patients aged from 20 to 60 years were selected in our hospital from July 2013 to December 2013，whom were 24 males and 21 females，with the BMI 17-23 kg/m2 and ASAI-Ⅱ level， the intravenous general anesthesia were underwent. Propofol and remifentanil anesthesia protocol was introduced and maintained with Target-controlled infusion(TCI) in supine position.5 min after reaching steady-state target concentration，the patients were changed in Trendelenburg position(30 degrees) and maintained about 10 min；10 min later，the position into anti-trendelenburg position were changed (30 degrees)，also maintained about 10 min. Narcotrend Index (NI)， mean arterial pressure (MAP)， heart rate (HR)， end-tidal carbon dioxide partial pressure (PETCO2) were recorded separately at the time points of before trendelenburg position(T0)，immediately(T1)，1 min (T2) later， 3 min(T3) later，5 min(T4) later and 10 min(T5) later after in Trendelenburg position and anti-trendelenburg position.Result：Compared the parameters in supine position(T0)，patients’ MAP in Trendelenburg position at the time point of T2-5 increased，also the NI at the time piont of T2-4 ，the difference was statistically significant (P<0.05).While， they were decreased in anti-trendelenburg position..The MAP at the point of T2-5，NI at the point of T2-4 were significantly lower in Trendelenburg position than in anti-trendelenburg position，the difference was statistically significant (P<0.01).Conclusion：Patients’ body position during intravenous anaesthesia can affect the Narcotrend index， of which will affect the anesthesiologists to judgment patients’ anesthesia depth.
【Key words】 Position； Narcotrend index； Intravenous anaesthesia
First-author’s address：Xiaolan Affiliated Hospital of Southern Medical University，Zhongshan 528415，China, 百拇医药(杨纲华等)