Narcotrend麻醉深度监测在无痛小肠镜检查中的应用

Application of narcotrend-assisted anesthesia in-depth monitor in small intestinal enteroscopy

目的探讨Narcotrend(NT)麻醉深度监测在无痛小肠镜检查丙泊酚-芬太尼全凭静脉麻醉中的应用。方法 40例行经口小肠镜检查的患者,随机分为两组:Narcotrend组和临床组,每组20例。两组患者均接受异丙酚-芬太尼全凭静脉麻醉。Narcotrend组患者术中根据Narcotrend值(NI)维持在D2～E0调节麻醉深度,临床组患者根据心率、血压及患者体动调节麻醉深度。分别记录两组患者的血流动力学、清醒时间、定向力恢复时间、异丙酚和芬太尼用量及术后患者的恶心呕吐发生率。结果两组患者相对应时段的血流动力学变化差异无显著性(P>0.05);Narcotrend组患者丙泊酚用量比临床组减少,苏醒时间和定向力恢复时间比临床组缩短,差异有显著性(P<0.05);两组患者芬太尼用量及恶心呕吐发生率差异无显著性(P>0.05)。结论 Narcotrend麻醉深度监测在无痛小肠镜检查丙泊酚-芬太尼全凭静脉麻醉中应用有助于减少丙泊酚用量,缩短患者恢复和清醒的时间。

[Objective] To explore the application of Narcotrend-assisted anesthesia in-depth monitor in small intestinal enteroscopy during total intravenous anesthesia with propofol and fentanyl. [Methods] 40 patients ASA Ⅰ～Ⅱ, requiring small intestinal enteroscopy were randomly divided into Narcotrend group and clinical practice group, 20 patients in each group. All patients received total intravenous anesthesia with propofol and fentanyl. The patients in the Narcotrend group were adjusted anesthesia in-depth according to Narcotrend and Narcotrend index was maintained between D2 and E0.Those in the clinical practice group adjusted anesthesia in-depth according to heart rate, mean arterial pressure, and patient movement. Changes of hemodynamics and the durations of emergence and orientation recovery were recorded. The doses of propofol and fentanyl, and the incidence of postoperative nausea and vomiting were also recorded. [Results] There were no significant changes of heart rate or mean arterial pressure between two groups （P 0.05）. The doses of propofol were less in the Narcotrend group than in the clinical group （P 0.05）. The durations of emergence and orientation were longer in the clinical group than in the Narcotrend group （P 0.05）. There were no differences in the dose of fentanyl, and the incidence of postoperative nausea and vomiting between two groups （P 0.05）. [Conclusions] Narcotrend-assisted anesthesia in-depth monitor in small intestinal enteroscopy can contribute to reducing the dose of propofol and shortening the duration of recovery during total intravenous anesthesia with propofol and fentanyl.