Narcotrend在体外循环心脏手术麻醉中的应用

Application of Narcotrend in anesthesia for cardiac surgery with cardiopulmonary bypass.

目的探讨Narcotrend在体外循环心脏手术麻醉中应用的安全性和优越性。方法 40例行体外循环心脏外手术患者随机分为A,B两组,A组为传统方法给药组,B组为Narcotrend指导下给药组。记录A,B两组患者患者麻醉诱导前(T1),插管后2min(T2),CPB前(T3),主动脉阻断后10min(T4),停机后10min(T5)的血压,心率,CVP和Narcotrend指数。统计患者的异丙酚,七氟醚用量,及术后72h患者的精神症状。结果 A组Narco-trend指数在T2,T3,T4,T5明显低于B组(P<0.05),尤其是在体外循环期间A组的Narcotrend指数下降幅度显著大于B组。A,B两组的血流动力学稳定,两者之间差异无统计学意义(P>0.05)。A组异丙酚,七氟醚用量明显多于B组(P<0.05),术后72h随访,A,B两组患者均未出现术中知晓和精神异常。结论 Narcotrend能安全的在体外循环心脏手术麻醉中应用,Narcotrend的应用能减少麻醉药的用量和防止过深的麻醉,指导心脏麻醉过程中的合理用药。

Objective To explore the safety and advantages of applying Narcotrend in anesthesia for cardiac surgery with cardiopulmonary bypass （CPB）. Methods Forty patients who underwent cardiac surgery with cardiopul-monary bypass were randomly divided into two groups. Patients in group A appied traditional method for treatment, while those in group B were treated under Narcotrend guidance. The blood pressure, heart rate, CVP and Narcotrend index were recorded before anesthesia induction （T1）, 2 minutes after intubation （T2）, before CPB （T3）, 10 minutes af- ter aortic blocking （T4）, and 10 minutes after stopping CPB （T5）. The dosage of propofol and sevoflurane, patients＇ mental symptoms after 72 hours were investigated. Results The Narcotrend indexes was significantly lower in group A than group B （P〈0.05）, especially during cardiopulmonary bypass. The hemodynamic indexes were stable, showing no statistically significant difference between the two groups （P〉0.05）. The dosage ofpropofol, sevoflurane was signif-icantly more in the group A than group B （P〈0.05）. 72 hours after surgery, no intraoperative awareness and mental dis-orders were found in the two groups. Conclusion Narcotrend is safe to be applied in anesthesia for cardiac surgery with cardiopulmonary bypass. The application of Narcotrend can reduce the dosage of the anesthetics and prevent deep anesthesia, and guide the rational use of drugs during anesthesia for cardiac surgery.