麻醉趋势指数预测靶控输注丙泊酚镇静深度的有效性分析

Efficacy of narcotrend index for predicting sedation depth during target-controlled infusion with propofol

目的探讨麻醉趋势指数(NI)预测靶控输注丙泊酚麻醉患者镇静深度的有效性。方法 30例择期全身麻醉手术患者,美国麻醉医师协会(ASA)分级Ⅰ级或Ⅱ级,靶控输注丙泊酚麻醉诱导,初始丙泊酚效应室靶浓度(Ce)为1.5 mg.L-1,每10 min增加0.5 mg.L-1。每20 s行改良警觉/镇静(MOAA/S)评分,MOAA/S评分为0时结束试验。应用Narcotrend麻醉深度监测仪监测NI。记录不同MOAA/S评分时患者的心率(HR)、平均动脉压(MAP)、Ce及NI值。结果随着MOAA/S评分的降低,NI值逐渐降低,差异有统计学意义(P<0.01)。MOAA/S评分与NI呈正相关。NI的预测概率(Pk)>0.85,与Pk=0.50比较,差异有统计学意义(P<0.01)。结论 NI能够有效预测靶控输注丙泊酚麻醉患者的镇静深度。

Objective To evaluate the efficacy of narcotrend index（NI） for predicting the sedation depth during target-controlled infusion（TCI） with propofol. Methods Thirty patients,American Society of Anesthesiologists（ASA）I or Ⅱ grade,scheduled for elective surgery under general anesthesia were enrolled.Anesthesia was induced by TCI with propofo1 in steps,the initial effect site concentration（Ce） of propofol was 1.5 mg·L-1,which was increased by 0.5 mg·L-1 every 10 minutes.The modified observer′s assessment of alertness/sedation（MOAA/S） score was recorded every 20 second.The experiment was ended when the MOAA/S score was 0.NI values were monitored by Narcotrend.The heart rate（HR）,mean arterial pressure（MAP）,Ce and NI were recorded when different MOAA/S scores. Results Following the MOAA/S score decreased,but NI values were lower gradually（P0.01）.The MOAA/S score was positively correlated with NI.The prediction probability（Pk） values of NI exceeded 0.85,which was significant difference compared with Pk=0.50（P0.01）. Conclusion NI can predict the depth of sedation produced by TCI with propopol effectively.