Narcotrend监测系统对腹腔镜手术宫颈癌患者动脉压、心率及术后痛觉过敏的影响

Effects of Narcotrend monitoring system on arterial pressure,heart rate and postoperative hyperalgesia in patients with cervical cancer under laparoscopy

目的探讨Narcotrend(NT)监测系统对腹腔镜手术宫颈癌患者动脉压(MAP)、心率(HR)及术后痛觉过敏的影响。方法选取96例宫颈癌患者作为研究对象,用随机数字表法均分为对照组和观察组,对照组采用常规监测,观察组采用NT监测调整麻醉用量,分别记录2组患者术前(t 1)、术毕(t 2)、术后24 h(t 3)时的平均MAP和HR,比较分析2组患者的手术相关情况,应激反应及术后痛觉过敏情况。结果观察组总有效率(95.83%)显著高于对照组(91.67%),差异有统计学意义(P<0.05);观察组麻醉苏醒时间、拔管时间和定向力恢复时间均短于对照组,丙泊酚用量低于对照组,差异有统计学意义(P<0.05);2组患者术中知晓率比较差异无统计学意义;观察组t 1、t 2及t 3时的MAP和HR的变化较对照组更平稳,差异有统计学意义(P<0.05);2组血氧饱和度(SpO 2)比较差异无统计学意义;观察组患者t 2及t 3时的皮质醇(Cor)、白细胞介素-6(IL-6)和C反应蛋白(CRP)水平均低于对照组,差异有统计学意义(P<0.05);观察组术后2,12和24 h视觉模拟(VAS)评分均低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率(8.33%)低于对照组(12.50%),差异有统计学意义(P<0.05)。结论腹腔镜手术宫颈癌患者行NT监测,可显著提高麻醉镇静深度判断的准确性,减少患者MAP和HR等生命体征的波动,术后痛觉过敏低,苏醒时间缩短,值得推广应用。

Objective To investigate the effect of Narcotrend(NT)monitoring system on mean arterial pressure(MAP),heart rate(HR)and postoperative hyperalgesia in patients with cervical cancer under laparoscopy.Methods 96 cases of cervical cancer patients were divided into control group and observation group according to the method of random number.The control group were monitored by conventional method,while the observation group were monitored by NT to adjust the dose of anesthesia monitoring.The MAP and HR at the time of before operation(t 1),after operation(t 2)and after operation 24 h(t 3)were recorded.The stress response and postoperative lgesia related to the operation were observed and compared.Results The total effective rate of the observation group was 95.83%significantly higher than that of the control group(91.67%),and the difference was statistically significant(P<0.05).The anesthesia recovery time,extubation time and directional force recovery time of the observation group were shorter than those of the control group,and propofol dosage was lower than that of the control group,the difference was statistically significant(P<0.05).There was no significant difference in intraoperative awareness rate between the 2 groups.The changes of MAP and HR in t 1,t 2 and t 3 of the observation group were more stable than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in blood oxygen saturation(SpO 2)between the 2 groups.The levels of cortisol(Cor),interleukin-6(IL-6)and C-reaction protein(CRP)in t 2 and t 3 stages in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).VAS scores at 2,12 and 24 h after operation in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was 8.33%lower than that in the control group(12.50%),and the difference was statistically significant(P<0.05).Conclusion Anesthesia trend monitoring under laparoscopy can significantly improve the accuracy of determining the depth of anesthesia sedation in patients with cervical cancer,reduce the fluctuation of vital signs such as MAP and HR,and shorten the waking time.Therefore,it is worth popularizing and applying.