Narcotrend麻醉监测系统在脑动脉瘤栓塞术中的应用

The application of Narcotrend anesthesia monitoring on cerebral aneurysm embolization operation

目的评价Narcotrend监测系统用于脑血管动脉瘤栓塞术的价值。方法将笔者所在医院全身麻醉下脑动脉瘤栓塞术患者80例随机分为两组:A组(Narcotrend监测组,n=39)根据Narcotrend监测值调整药物用量,维持Narcotrend监测值在D2-E0之间;B组(常规监测组,n=41)凭血流动力学变化和临床经验控制麻醉深度。比较两组患者麻醉时间、丙泊酚用量、苏醒时间、拔除气管导管时间。记录术中血压波动、麻醉恢复期低氧血症、术中知晓及24 h内恶心呕吐等的发生情况。结果与B组比较,A组丙泊酚总用量减少明显(P<0.05),低血压发生率较低(P<0.05),苏醒及拔管时间均显著缩短(P<0.05),低氧血症发生率低(P<0.05)。结论Narcotrend监测系统应用于脑动脉瘤栓塞术能精确预测麻醉深度,指导合理用药,对提高麻醉安全性和质量有很好的指导意义。

Objective To investigate the value of narcotrend anesthesia monitoring on the cerebral aneurysm embolization operation.Methods Eighty patients underwent cerebral aneurysm embolization operation in our hospital were randomly divided into two groups:Group A(Narcotrend-guided TCl with propofol and remifentanil),Group B(TCl with propofol and remifentanil).Group A was adjusted the concentration of propofol depending on Narcotrend which being maintained between D2-E0,While Group B was adjusted the concentration of propofol depending on clinical experience and hemodynamic changes.The total operation time dosage of propofol,duration of recovery and extubation were compared between the two groups.The incidence of restlessness and hypoxemia at extubion were recorded.In traoperative awareness and incidence of nausea and vomiting were also recorded after 24 hours.Results In comparison with the two groups,the total of propofol in group A decreased obviously(P<0.05).The duration of recovery and extubation of group A was shorter than that in group B(P<0.05).The recovery of consciousnes tidal volume and respiratory rate of group A was faster than that in group B.Incidence of hypoxemia was lower in group A(P<0.05).Conclusion Narcotrend anesthesia monitoring can improve the surgical safety and anesthetic accuracy which is suitable for the cerebral aneurysm embolization operation.