咪达唑仑靶控输注时镇静深度与Narcotrend指数的相关性研究

Study on correlation between depth of sedation and Narcotrend index in Midazolam target-controlled infusion

目的 探讨Narcotrend用于咪达唑仑镇静深度监测的可靠性及镇静深度[改良警觉镇静评分（OAA/S）]与Narcotrend指数的相关性.方法 选择ASA Ⅰ～Ⅱ级择期行椎管内麻醉下下肢手术患者60例,给予静脉靶控输注咪达唑仑,血浆靶控浓度从50 ng/ml开始,以10 ng/ml的梯度逐步升高目标浓度,每一阶段维持5 min,当OAA/S评分为1分时停药,观察至OAA/S评分达5分,若手术尚未结束,调控至合适的镇静深度直至手术结束,记录不同OAA/S评分时的Narcotrend指数、心率、平均动脉压、呼吸的变化.结果 镇静加深期、恢复期OAA/S评分与Narcotrend指数均显著相关（r=0.786、0.652,均P＜0.05）.结论 Narcotrend 能很好指导咪达唑仑靶控输注,其指数与咪达唑仑镇静深度密切相关.

Objective To investigate the reliability of Narcotrend for monitoring the depth of sedation[ the observer＇s assessment of alternes.s/sedation（OAA/S） scale] with midazolam and correlation between the depth of seda- tion and Narcotrend index. Methods 0 ASA I-1] status patients scheduled for elective lower limb operations under- went spinal anesthesia, who were given target-controlled infusion of midazolam. Target plasma concentration was 50ng/ ml at first and increased by 10 ng/ml each grade until OAA/S scale became 1 point. Each target concentration infu- sion was maintained for 5rain. Observe the patient the OAA/S scale to be 5 points. If the operation was not over yet, regulated the appropriate depth of sedation until the end of operation. The Narcotrend index, of different OAA/S scale and heart rate, meanarterial pressure, respiration were recorded. Results In the deepening or recovery phase of se- dation, OAA/S scales were correlated with Narcotrend index （ Spearman＇ s r = 0. 786,0. 652, all P 〈 0. 05 ）. Conclusion Narcotrend is a good index to guide target controlled infusion of midazolam,the index is closely related with the depth of sedation of midazolam.