摘要
目的比较不同Narcotrend指数（Narcotrend index,NTI）下老年患者全麻术中脑氧代谢的变化。方法择期行腹部手术（术式不限,手术时间短于2h）的老年患者90例,随机均分为A、B、C组,术中NTI分别维持在D0、D2和E1。分别采集麻醉诱导前（T0）、NTI达到预定值后10min（T1）、30min（T2）、关腹即刻（T3）和术毕时（T4）桡动脉及颈静脉球部血样行血气分析,记录并计算颈内静脉球部血氧含量（SjvO2）、桡动脉-颈内静脉球部血氧含量差（Da-jvO2）及乳酸差（VADL）、脑氧摄取率（CERO2）。结果 T1~T4时B和C组SjvO2明显高于,Da-jvO2、CERO2明显低于T0时和A组（P〈0.05）;T1~T4时C组SjvO2明显高于B组（P〈0.05）。结论老年患者全麻术中NTI维持在D0、D2和E1时,脑氧代谢虽发生变化,但并未破坏大脑正常的氧供-氧耗平衡。
Objective To investigate the effects of different narcotrend index（NTI）on cerebral oxygen metabolism in elderly patients with general anesthesia. Methods Ninety elderly patients un- dergoing selective abdominal surgery （less than 2 b） were randomly divided into 3 groups, including group A （anesthesia depth maintained with the target of NTI at Do level）, group B （NTI at Do level） and group C （NTI at E1 level）. 10 rain before anesthesia induction （T0）, 10 rain after NTI at preset index （T1）, 30 rain after NTI at preset index （T2）, abdominal closure immodiately （T3）, at the end of the surgery （T4）, MAP and HR were recorded and blood-gas analysis was performed after the blood was taken from radial artery and the internal carotid vein. jugular bulb oxygen content （SjvO2）, cerebral arterial to jugular venous oxygen content difference （Da-jvO2）, cerebral oxygen uptake rate （CERO2） and radial artery-internal jugular bulb lactic acid difference （VADL） were calculated. Results MAP at T1 to T4 in all three groups increased significantly compared to To. Comparing to To, SjvO2 increased while Da-jvO2 and CERO2 decreased in groups B and C at T1 to T4 （P〈0. 05）. SjvO2at T1 to T4were lower while Da-jvO2 and CERO2 were higher in group A than in groups B and C （P〈0.05）. SjvO2 at T1 to T4 were higher in group C than in group B （P〈0.05）. Conclusion When NTI maintained at Do, 192 and El, the cerebral oxygen metabolism were influenced, but without sig- nificant disturbance to the cerebral oxygen supply and consumption balance.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2015年第11期1070-1072,共3页
Journal of Clinical Anesthesiology
