Narcotrend麻醉深度监测仪在妇科丙泊酚喉罩全静脉麻醉手术中的应用  

Application of Narcotrend monitor in propofol-laryngeal mask total intravenous anesthesia ofgynecilogical surgery

作　　者：盛开花[1] 龚志毅[2] 陈雪华[1] 

机构地区：[1]北京潞河医院麻醉科,101149 [2]北京协和医院麻醉科

出　　处：《肿瘤研究与临床》2012年第9期620-621,624,共3页Cancer Research and Clinic

摘　　要：目的 观察Narcotrend（NT）麻醉深度监测仪在妇科丙泊酚—喉罩（LMA）全静脉麻醉手术中的应用，探讨其对置入喉罩时机和患者意识恢复的预测效果。 方法 选择30例ASA分级I级的行丙泊酚静脉麻醉喉罩插管的妇科手术患者，采用Graseby3500-TCI， NT监测麻醉深度，用ZEUS麻醉机的自动控制模式控制呼吸，观察患者在入睡、置入喉罩、停药、自主呼吸、睁眼时NT值（NTI）、NT分级（NTS）、丙泊酚效应室浓度（Ce）和血流动力学指标。术后随访有无术中知晓情况。结果 与入睡时相比，患者插入喉罩时的NT值[（77±23）与（30±9），z=5.561 p〈0.01]、丙泊酚效应室浓度（Ce）[（1.1±0.4）μg/ml与（2.2±0.4）μg/ml，z=6.38 p〈0.01]、平均动脉压（MAP）[（92±14）mmHg与（83±14）mmHg，t=2.490 p〈0.05]、心率（HR） [（74±15）次/min与（65±10）次/min，t=2.688 p〈0.01]的差异有显著意义（p〈0.05）；与停药时相比，自主呼吸恢复时的NT值[（37±7）与（71±14），z=6.34]的差异有显著意义（p〈0.01）；与停药时相比，睁眼时的NT值[（37±7）与（83±13），z=6.668 p〈0.01] 、丙泊酚效应室浓度[（3.1±0.4）μg/ml与（1.6±0.2）μg/ml，z=6.414 p〈0.01]、心率[（59±7）次/min与（64±8）次/min，t=-2.825p〈0.01]的差异有显著意义（p〈0.01）。术后随访无术中知晓。结论麻醉深度监测仪能有效的指导妇科全静脉麻醉手术中喉罩的置入和拔除。Objective To evaluate the predictive effect of Narcotrend（ NT ） monitor on LMA intubation and consciousness recovery in propofol-LMA intravenous anesthesia Methods Thirty ASA I or II patients undergoing elective gynecilogical surgery under general anesthesia with laryngeal mask intubation were anesthetized with propofol by target- controlled infusion （TCI）. Narcotrend monitor was used to monitor the anesthesia depth. The ventilation was used the closed circuit breathing mode （Autocontrol） of ZEUS anesthesia machine. The values of NT stage （ NTS） , NT index （ NTI） , the effect compartment concentration （ Ce） and hemodynamic parameters were recorded during the time of sleeping, laryngeal mask intubation, propofol stopping pumping, recovery of spontaneous respiration ,eyes opening.The incidence rate of intraoperative awareness were recorded. Results The values NT index （ NTI） [（77±23）与（30±9）,z=5.561 p〈0.01] , the effect compartment concentration （ Ce） [（1.1±0.4）μg/ml与（2.2±0.4）μg/ml,z=6.38 p〈0.01] ,MAP[（92±14）mmHg与（83±14）mmHg,t=2.490 p〈0.05] and HR [（74±15）bpm与（65±10）bpm,t=2.688 p〈0.01]of the time of intubation were significantly decreased compared to the time of sleeping（p〈0.05）. The values NT index （ NTI） [（37±7）与（71±14）,z=6.34]of the time of recovery of spontaneous respiration was significantly increased compared to the time of propofol stopping pumping （p〈0.01）. The values NT index （ NTI） [（37±7）与（83±13）,z=6.668 p〈0.01] , the effect compartment concentration （ Ce） [（3.1±0.4）μg/ml与（1.6±0.2）μg/ml,z=6.414 p〈0.01] and HR[（59±7）bpm与（64±8）bpm,t=-2.825p〈0.01] of the time of eyes opening were statistically significant compared to the time of propofol stopping pumping （p〈0.01）. None of patients experienced intraoperative awareness. Conclusion Narcotrend（ NT ） monitor can effectively guide the intubation and extubation of laryngeal mask in total

关 键 词：NARCOTREND 丙泊酚 效应室浓度 静脉麻醉 喉罩 

分 类 号：R614[医药卫生—麻醉学]