Narcotrend与BIS在右美托咪定镇静效应中的对比

Comparison on Effect of Dexmedetomidine between Narcotrend and BIS

目的:评价Narcotrend(NT)与脑电双频谱指数(BIS)在监测右美托咪定麻醉诱导的优劣情况。方法:ASA分级I或Ⅱ级,择期行腹腔镜手术的患者60例,将其随机数字表法分成NT组和BIS组,每组30例,诱导开始时采用微量泵输注右美托咪定1.0μg/kg,输注时间为10 min。输注5 min后开始静脉注射丙泊酚1.5 mg/kg、芬太尼4μg/kg、阿曲库铵0.15 mg/kg,输注右美托咪定10 min后行气管插管,并分别测定诱导前(T0)、气管插管前(T1)、气管插管时(T2)、插管后1 min(T3)和5 min(T4)时的BIS值、NT值、平均动脉压(MAP)和心率(HR)。结果:NT和BIS评分呈直线正相关(r=0.901,P<0.01);与诱导前比较,气管插管前BIS值、NT值、MAP和HR均明显降低(P<0.05);与气管插管前(T1)比较,气管插管时(T2)、插管后1 min(T3)和5 min(T4)的BIS值、NT值、MAP和HR差异无统计学意义。结论:NT可准确监测靶控输注右美托咪定的镇静效应,与BIS相比无明显差异。

Objective： To evaluate the advantages and disadvantages of Narcotrend （NT） in monitoring the depth of anesthesia when compared with the bispectral index（BIS）.Method： 60 patients （ASA I orⅡ）, undergoing elective laparoscopic surgery, were randomly divided into two groups, NT group and BIS group. 1.0 μg/kg dexmedetomidine was injected with a micro infusion pump, fusion time was 10 minutes. 1.5 mg/kg propofol, 4 μg/kg fentanyl and 0.15 mg/kg atracurium was injected intravenously after dexmedetomidine was injected 5 minutes. Tracheal intubation was placed after demedetomidine was injected 10 minutes. BIS, NT, mean arterial pressure （MAP） and heart rate （HR） were measured before induction （T0）, before intubation （T1）, instant time after intubation （T2）, 1 minute （T3）, and 5 minutes （T4） after intubation.Result： The NT index was positively correlated to the BIS （r=0.901,P〈0.001）; HR, MAP, NT and BIS values were significantly lower after dexmeddetomidine administration （P〈0.05）. NT and BIS values significantly decreased at loss of consciousness as compared with the baseline value （P〈0.01）. Compared with that before intubation, HR and MAP increased during intubation, and at l and 3 mins after intubation, while no significant change was found in HR, MAP, NT and BIS values.Conclusion： NT can monitor sedative effect induced by dexmeddetomidine accurately. NT and BIS are comparable no advantages.