Narcotrend在全凭静脉麻醉中的应用

Clinical Effects of Narcotrend Monitor in total intravenous anesthesia

目的观察Narcotrend麻醉深度监测仪应用于全麻患者的临床疗效。方法选择我院ASAⅠ-Ⅱ级成年人腹部手术全麻100例,随机分为两组:Narcotrend(NT)麻醉深度监测组(A组,即实验组);经验给药组(B组,即对照组)。比较两组患者在T1(NT数值数据出现3min后)、T2(插管)、T3(切皮)、T4(缝皮)、T5(意识恢复)、T6(气管拨管)、T7(出室)7个时间点的平均动脉压(MAP)、心率(HR),以及两组患者的麻醉药物用量、苏醒时间、拔管时间及术中知晓率。结果实验组在插管时、切皮时及拔管时的MAP及HR与对照组比较,差异有统计学意义(P<0.05);实验组在入室NT数值出现3min后、缝皮时、意识恢复时及出室时的MAP及HR与对照组比较,差异无统计学意义(P>0.05)。实验组在整个实验过程中所用丙泊酚总量、瑞芬太尼总量、维库溴铵总量、及患者的苏醒时间、拔管时间与对照组比较,差异均有统计学意义(P<0.05)。术后48h随访两组患者均无术中知晓(P>0.05)。结论 NT麻醉深度监测仪用于全凭静脉麻醉有利于控制麻醉深度,使用较少的麻醉药物达到最佳的麻醉效果,缩短复苏过程。

Objective To explore the clinical effects of Narcotrend monitor （NT） in total intravenous anesthesia. Methods One hundred patients （ ASA grade I - 11 ） undergoing selective general anesthesia were randomly divided into observation group and control group （n = 50 for each group）. The NT was used in observation group but not in the control group to monitor the anesthesia depth of patients ~ The mean arterial pressure （MAP） ,heart rate （HR）, NT stages （NTS） and NT index （NTI） were determined on the time points of anesthetic induction（ T1 ） , intubation（ T2 ） , skin incision（ T3 ） , sewing skin（T4） , awareness recovery（ T5 ） , postanesthesia tracheal extubation（ T6）, and going out the operation room （T7）. The total doses of sedatives and muscle relaxant, the recovery time, the extubation time and the incidence rate of intraoperative awareness were recorded. Results The MAP and HR are significant difference between observation group and control group on the time points of intubation （ T2）, skin incision （ T3 ） and post-aaesthesia tracheal extubation （T6） （ P 〈 0. 05 ）. However, The MAP and HR are not difference between observation group and control group on the time points of anesthetic induction （ T1 ）, sewing skin （ T4 ）, awareness recovery （ T5 ） and going out the operation room （ T7 ） （P 〉 0.05 ）. The doses of midazolam, propofol, remifen-tanil and doxapram used in patients of observation group were significantly fewer than those in controlgroup. Compared with those of control group（ P 〈 0. 05 ）. The recovery time, the extubation time of intraoperative awareness were significantly decreased in the observation group （P 〈 0.05）. The incidence rate of intraoperative awareness were not difference in the observation group and control group （P 〉 0.05 ）. Conclusion With NT, the doctor can use fewer sedatives and get the best anesthesia effects, shorter recovery time.