Narcotrend监测下不同麻醉深度对老年患者无痛肠镜检查临床效果的比较  

Comparison of clinical effect of different anesthesia depth under the Narcotrend monitoring in elderly patients with painless colonoscopy

作　　者：何干玲[1] 周晓筠[1] 郭建忠[1] 方宁[1] 陈明湖[1] 林霞[1] 

机构地区：[1]广东省中山市博爱医院麻醉科,广东中山528400

出　　处：《中国当代医药》2015年第8期131-132,137,共3页China Modern Medicine

基　　金：广东省中山市卫生局医学科研项目(2013J121)

摘　　要：目的研究Narcotrend监测下不同麻醉深度对老年患者行无痛肠镜检查的临床效果。方法将2013年6-12月90例拟行无痛肠镜检查的老年患者随机分为3组,每组30例,均给予丙泊酚-芬太尼全凭静脉麻醉,在NT监测下调整靶控浓度,维持A、B、C组患者的NT指数（NTI）分别在E0（27-36）、D2（37-46）、D1（47-56）水平后进行检查。记录3组患者的检查及苏醒时间、丙泊酚用量以及不良反应发生情况。结果 A组的苏醒时间为（11.3±0.9）min,较B、C组长（P〈0.05）。A组的丙泊酚用量显著多于B、C组,且低血压、呼吸抑制及心动过缓发生率也高于B、C组（P〈0.05）,B组的总不良反应发生率低于A、C组（P〈0.05）,且无术中知晓情况的发生。结论 NT监测下行老年人无痛肠镜检查,较好的麻醉深度为D2（37-46）,可降低不良反应发生率,减少丙泊酚用量。Objective To investigate the clinical effect of different anesthesia depth in elderly patients with painless eolonoseopy under the NT monitoring. Methods 90 elderly patients with scheduled for painless colonoscopy from June to December 2013 were randomly divided into the three groups,and there were 30 cases in each group.All patients re- ceived the total intravenous anesthesia of propofol-fentanyl.Adjusting the target controlled concentration under the NT monitoring to maintain the NT index （NTI） of patients in the group A,B and C for E0 （27-36）,D2 （37~46）,D1 （47-56） level before check. The check and recovery time,the dosage of propofol and the incidence rate of adverse reaction in the three groups were recorded. Results The recovery time of the group A [（11.3±0.9） min] was longer than that of the group B and C （P〈0.05）. The dosage of propofo] in the group A was significantly higher than that in the group B and C, the incidence rate of hypotension,respiratory depression, bradyeardia of the group A was higher that in the group B and C respectively （P〈0.05）.Overall incidence rate of adverse reaction of the group B is lower than that in the group A and C （P〈0.05）,and there was no occurrence of intraoperative awareness situation in the. group B. Conclusion D2 （37-46） is the better anesthesia depth for elderly patients with painless colonoscopy under the NT monitoring, which can reduce the incidence rate of adverse reaction and the dosage of propofol.

关 键 词：Narcotrend监测 无痛肠镜 丙泊酚 

分 类 号：R614.24[医药卫生—麻醉学]