Narcotrend麻醉深度监测仪预防全身麻醉术中知晓的研究  

Research of Narcotrend monitor for the prevention of awareness during general anesthesia

作　　者：梁斌[1] 郑恒兴[1] 张康秦[1] 余宣民 王红运[1] 谢小伟[1] 赵蕊[1] 

机构地区：[1]陕西省宝鸡市中心医院麻醉手术科,721008

出　　处：《中国医师进修杂志》2011年第33期4-8,共5页Chinese Journal of Postgraduates of Medicine

基　　金：陕西省宝鸡市卫生局科研项目（2009-01）

摘　　要：目的研究Narcotrend（NT）麻醉深度监测仪用于预防全身麻醉术中知晓的临床效果及安全性。方法择期手术气管插管全身麻醉患者432例，ASA分级Ⅰ～Ⅱ级，采用随机数字表法分为观察组和对照组，每组216例，均采用全凭静脉麻醉。观察组根据NT麻醉深度监测仪指导给予麻醉药，对照组根据麻醉医师临床经验判断给予麻醉药。分别观察记录平均动脉压、心率、呼吸频率、脉搏血氧饱和度；记录NT分级、NT指数；记录各药物用量、苏醒时间、拔管时间；记录Ramsay评分；于术后第1、4天各随访1次，了解患者术中感知和记忆情况。结果观察组无术中知晓，对照组怀疑有知晓及肯定知晓各1例。观察组与对照组比较，苏醒时间、拔管时间均降低[（6．0±2．8）min比（10．0±4．9）min，（12．0±5．5）min比（19．0±6．9）min]（P〈0．05）；平均动脉压、心率更为平稳；除咪达唑仑外，其余各药物用量更少（P〈0．05）；意识恢复、气管拔管、出手术室时Ramsay评分更低（P〈0．05）。结论NT麻醉深度监测仪用于全凭静脉麻醉，提高了全身麻醉的安全性，可以在一定程度上降低术中知晓率。Objective To study the clinical efficacy and safety of Narcotrend （NT） monitor for the prevention of awareness during general anesthesia. Methods Four hundred and thirty-two patients with elective extubation and general anesthesia （ASA Ⅰ - Ⅱ ） were divided into observation group and control group with 216 cases each by random digits table. All patients were treated with total intravenous anesthesia. The patients were given anesthetics by NT monitor in observation group and detemined by the clinical experience of anesthesiologists in control group. The mean arterial pressure （MAP）,heart rate （HR）, respiratory rate （RR）, pulse oxygen saturation （SpO2）, NT stages （NTS）, NT index （NTI）, total sedatives, awaking time, extubation time, Ramsay score was recorded. All patients in the postoperative on the first day and the fourth day were followed-up two times to understand the perception and memory in patients undergoing the situation. Results There was no know in operation in observation group, there was 1 case with suspected know and 1 case with definite know in control group. Compared with control group, the awaking time and extubation time was decreased in observation group [ （6.0 ± 2.8） min vs. （ 10.0 ± 4.9）rain, （ 12.0 ± 5.5 ） rain vs. （ 19.0 ± 6.9） min] （P 〈 0.05 ） ; MAP and HR was even more stable. In addition to midazolam, the remaining amount of the drug was less （P 〈 0.05 ）. Ramsay score at awaking, extubation and out of the operating room in observation group was lower than that in control group （P 〈 0.05）. Conclusion NT monitor for total intravenous anesthesia increases the safety of general anesthesia, and it can be reduced to some extent, intraoperative awareness.

关 键 词：麻醉 全身 术中知晓 麻醉深度 

分 类 号：R614[医药卫生—麻醉学]