Narcotrend监测在硬膜外麻醉丙泊酚靶控清醒镇静中的临床意义  

The Clinical Significance of Narcotrend Monitoring in Propofol Target Controlled Infusion for Awak-sedation in Epidural Anesthesia

作　　者：廖飞[1] 陈静宜[1] 朱雁鸿[1] 陈粤丽[1] 刘建平[1] 

机构地区：[1]昆明医科大学第六附属医院麻醉科,云南玉溪653100

出　　处：《昆明医科大学学报》2015年第2期119-122,共4页Journal of Kunming Medical University

摘　　要：目的探讨Narcotrend监测在硬膜外麻醉丙泊酚靶控清醒镇静中的临床指导意义.方法选择60例连续硬膜外麻醉下行中下腹部及下肢手术的患者,随机分为Narcotrend监测组(NT组)和传统改良清醒镇静评分组(OAA/S组),比较2组患者循环、呼吸参数变化;丙泊酚用量;是否需辅助通气和患者舒适度.结果 NT组、OAA/S组达镇静深度时丙泊酚效应室浓度分别为1.58μg/m L和1.79μg/m L(P>0.05);2组患者各个时间点循环、呼吸参数均无统计学差异(P>0.05),NT组心率(HR)、呼吸(RR)、平均血压(MAP)的术中变化较OAA/S组小;2组丙泊酚总用药量无统计学差异,但单位时间丙泊酚用量具有统计学差异(P<0.05);NT组苏醒时间小于OAA/S组,差异有统计学意义(P<0.05);辅助通气2组差异无统计学意义(P>0.05).结论 NT组比OAA/S组术中循环呼吸参数影响较小,单位时间丙泊酚用量少,苏醒较快;Narcotrend监测在硬膜外麻醉丙泊酚靶控清醒镇静中具有较好的临床指导意义.Objective To investigate the clinical significance of Narcotrend monitoring in ropofol target controlled infusion for awake-sedation in the epidural anesthesia. Methods Sixty paitents of continuous epidural anesthesia underwent operation at lower abdomen and lower limbs. All the patients were randomly divided into two groups： group NT（n=30） and group OAA/S（n=30）.We recorded and compared circulation and respiratory parameters,dosage of propofol,whether the required assisted ventilation and comfort degree of patients.Results When the sedation depth was reached, the propofol effect compartment concentrations in Group NT and group OAA/S were 1.58 μg/m L and 1.79 μg/m L（P〉0.05）,respectively. There were no statistically significant difference between the two groups in the circulation and respiratory parameters at each time point（P〉0.05）. The changes of the heart rate（HR）,respiration（RR）,mean blood pressure（MAP） during operating in group NT were less than group OAA/S.The total dosage propofol had no statistically significant difference between two groups, but the dosage of propofol in the unit time had statistically significant difference（P〈0.05）. The awakening time of patients in group NT was shorter than group OAA/S, with statistical difference（P〈0.05）. The assisted ventilation had no statistically significant difference between two groups. Conclusions In the process of operation, circulatory and respiratory parameters in group NT were less affected than in group OAA/S. And the dosage of propofol in the unit time in group NT was less than in group OAA/S. The paitents wake up more quickly in group NT. So, the Narcotrend monitoring in propofol target controlled for awak-sedation in the epidural anesthesia has better clinical significance.

关 键 词：Narcotrend监测 硬膜外麻醉 丙泊酚靶控 清醒镇静 

分 类 号：R614.2[医药卫生—麻醉学]