Narcotrend监测在异氟醚-舒芬太尼颅脑手术苏醒期的应用  

Application of Narcotrend monitoring during isoflurane-sufentanil craniocerebral operation recovery period

作　　者：张鑫[1] 雷明灿[1] 王勇[1] 田波[1] 

机构地区：[1]河南大学淮河医院麻醉科,河南开封475000

出　　处：《中国当代医药》2013年第4期94-95,97,共3页China Modern Medicine

摘　　要：目的观察Narcotrend监测在异氟醚-舒芬太尼颅脑手术苏醒期的预测作用。方法选择42例ASAⅠ～Ⅱ级在全麻下行择期手术的颅脑手术患者,随机分为Narcotrend监测组(NT组)和常规监测组(对照组),每组各21例。术中吸入异氟醚和泵入舒芬太尼维持麻醉,术毕记录麻醉苏醒期间出现吞咽反射、呼之睁眼、记忆力恢复时的MAP、HR、NT分级(NTS)和NT指数(NTI),并计算上述四种参数相对应意识变化阶段的预测概率值(PK)。结果 NTS、NTI与患者麻醉苏醒期意识水平的变化显著相关(P<0.05)。预测患者呼之睁眼的PK值分别为0.93±0.04、0.89±0.03,预测记忆力恢复的PK值分别为0.92±0.02、0.87±0.05均显著高于0.5(P<0.05),并且高于MAP、HR的相应预测值(P<0.05);与对照组比较,NT监测组的苏醒时间显著缩短(P<0.05),全麻药的用量明显减少。结论 Narcotrend监测能减少术中异氟醚和舒芬太尼的用量,缩短麻醉苏醒时间;Narcotrend监测与常规血流动力学指标的监测相比,在异氟醚-舒芬太尼颅脑手术患者苏醒期预测意识水平变化能力更加有效、客观。Objective To observe Narcotrend monitoring predicted in roles of isoflurane-sufentanil applied in cranio- cerebral surgery anesthesia recovery period. Methods Forty-two neurosurgieal patients who belongs to the grade of ASA I to II were selected and randomly divided into the Narcotrend monitoring group （NT group） and the routine monitoring group （control group）, each group had 21 cases. Isoflurane was inhaled and sufentanil was infusioned during operation. And the emergence of the swallowing reflex, eye opening, memory recovery, MAP, HR, the NT classification （NTS） and NT index （NTI） during anesthesia recovery period were recorded, then the Predicted Probability （PK） of the four parameters corresponding with awareness was calculated. Results There were significantly correlation between NTS, NTI and patients consciousness level （P 〈 0.05）. Prediction in patients with eye opening PK values were 0.93-＋ 0.04,0.89-＋0.03, predict the PK value memory recovery were 0.92＋0.02,0.87-＋0.05, it was significantly higher than 0.5 predicted values （P 〈 0.05）, also higher than the MAP, HR. Compared with the control group, the NT monitoring group could shorten waking time evidently （P 〈 0.05）, and reduced the amount of narcotic. Conclusion The Narcotrend mon- itoring can reduce the amount of isoflurane and sufentanil intraoperative and shorten the time of recovery from anes- thesia. The Narcotrend monitoring can predict the level of conscious modification more effective and objective in neu- rosurgical patients revive period which applys isoflurane-sufentanil.

关 键 词：NARCOTREND 颅脑手术 异氟醚 全麻苏醒期 血流动力学 

分 类 号：R614[医药卫生—麻醉学]