Narcotrend脑电意识深度监测系统在无痛ERCP中的临床观察  

作　　者：黄锡强[1] 苏圣贤[1] 张志刚[1] 林宏凯[1] 

机构地区：[1]广东省中山市人民医院麻醉科,528403

出　　处：《当代医学》2012年第34期8-10,共3页Contemporary Medicine

摘　　要：目的使用Narcotrend指数(NTI)在无痛内窥镜逆行胰胆管造影(ERCP)监测麻醉深度,评估其临床安全性、有效性,以确立无痛ERCP时恰当的NTI范围并指导临床。方法 90例住院行无痛ERCP患者参加本临床观察,Narcotrend监护仪监护术中镇静深度指数,通过靶控输注(TCI)异丙酚及瑞芬太尼,调整NTI水平并随机分成3组,每组30例,3组患者分别控制NTI值为:A组NTI=40～49,B组NTI=50～59,C组NTI=60～69。记录术中生命体征、呛咳体动、恶心呕吐、术中知晓等不良反应发生情况,记录操作时间、苏醒时间、麻醉药物用量等。结果 3组无痛ERCP患者中,A组及C组不良反应显著高于B组(P<0.05),A组苏醒时间最长,使用麻醉药物最多(P<0.05)。结论在无痛ERCP中使用Narcotrend脑电意识深度监测系统指导麻醉,NTI在50～59之间,具有较高的安全性和有效性。Objective To monitor the depth of anesthesia in painless endoscopic retrograde cholangiopancreatography （ERCP） by using Narcotrend Index （NTI）, assessing its clinical safety, efficacy, in order to establish the appropriate range of NTI in a painless ERCP and serve as a clinical guidance. Methods 90 cases of hospitalized patients that undertook painless ERCP attended this clinical observation. Narcotrend monitored intraoperative sedation depth index, the NTI level was adjusted by target-controlled infusion （TCI） of propofol and remifentail. All the patients were randomLy divided into three groups, 30 patients each. The NTI value of the three groups was： group A of NTI = 40 - 49, group B of NTI = 50 - 59, group C of NTI = 60 - 69, respectively. Recored the vital signs, adverse reaction, including cough, body movement, nausea, vomiting and intraoperative awareness. Also, the operating time, recovery time, the amount of narcotic drugs were recorded. Results Within all the three groups, adverse reactions in group A and group C was significantly higher than group B （P〈0.05）. The patients in group A took the longest time to wake up （P〈0.05） and consumed the largest amount of narcotic drugs （P〈0.05）. Conclusion Using Narcotrend electroencephalogram monitoring system to guide the process of anesthesia during painless ERCP, with NTI between 50 and 59, have more safety and efficacy.

关 键 词：NARCOTREND 麻醉深度 靶控输注 无痛ERCP 术中知晓 

分 类 号：R614[医药卫生—麻醉学]