Narcotrend麻醉深度监测在患儿无痛胃镜检查中的应用

The effect of Narcotrend monitor on anesthesia depth in pediatric painless gastroscopy

目的探讨Narcotrend麻醉深度指数（NI）指导患儿无痛胃镜检查中丙泊酚用药的可行性。方法 60例行无痛胃镜检查的患儿,随机均分为对照组（C组）、NI目标控制组（NI组）。两组患儿均给予丙泊酚2-3.5mg/kg缓慢静推,C组患儿肢体无自主扭动、按压眶上神经无反应后开始检查,术中有呛咳或体动时追加丙泊酚;NI组患儿注药前监测NI值,使患儿即时NI值降至D2（NI值46-37）,根据NI是否在目标控制范围适当追加用药。连续监测并记录两组患儿诱导前、意识消失、术毕、清醒时的HR、BP、SpO2,并记录两组患儿发生体动时的HR、BP、SpO2。记录两组患儿诱导时间、苏醒时间、丙泊酚用量、不良反应的发生情况。结果两组意识消失时的HR明显慢于,MAP明显低于诱导前（P〈0.05）;C组发生体动时的HR明显快于意识消失时（P〈0.05）;NI组苏醒时间明显短于,体动发生率明显低于C组（P〈0.05）。结论 Narcotrend麻醉深度监测对指导患儿无痛胃镜检查术中的丙泊酚用药有很好的指导意义,有效降低术中并发症发生率,且术后恢复快而完全。

Objective To explore the effect of Narcotrend anesthesia depth index（NI）on anesthesia in pediatric painless gastroscopy.Methods Sixty ASA Ⅰ or Ⅱ children undergoing painless gastroscopy were randomly divided into control group（group C）or Narcotrend group（group NI）with 30 cases each.All the children were given propofol 3to 5mg/kg intravenously.In the group C,the operation began without independent body twisting,additional propofol was given in the presence of body move or cough.In group NI propofol was given on the basis of the degree of NI,which maintaining the degree of D2（NI 46-37）.The induction time,emergence time,the dosage of propofol and the occurrence of adverse reactions were recorded.Results MAP and HR were both lower than baseline after anesthesia induction in the two groups（P〈0.05）.HR during body movement was higher than that during loss of consciousness in group C（P〈0.05）.the emergence time was shorter and the incidence of body movement was lower in group NI than those in group C（P 〈0.05）.Conclusion Narcotrend is a good anesthesia depth monitor during pediatric painless gastroscopy with reduced complication and faster recovery.