麻醉意识深度监测系统在小儿唇腭裂手术气管插管静脉全麻中的应用  

Application of Narcotrend in the Repair of Cleft Lip and Palate with General Anesthesia by Endotracheal Intubation in Children

作　　者：蓝扬[1] 游志坚[1] LAN Yang YOU Zhi-jian(Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou 515041 China)

机构地区：[1]汕头大学医学院第二附属医院麻醉科,广东汕头515041

出　　处：《汕头大学医学院学报》2017年第2期113-115,共3页Journal of Shantou University Medical College

摘　　要：目的:观察麻醉意识深度监测(NT)系统在小儿唇腭裂手术气管插管静脉全麻中的应用。方法:选择在气管插管静脉复合全麻下行唇腭裂修复术的学龄前(0~7岁)患儿40例,随机分为观察组(A组。全程在NT系统监测指导下调整静脉麻醉药物异丙酚用量)和对照组(B组。由资深麻醉医师常规进行诱导并根据生命体征变化调节静脉麻醉药物异丙酚用量)各20例。记录两组在入室(T0)、气管插管(T1)、手术开始(T2)、手术结束(T3)及拔除气管导管(T4)时的心率(HR)和平均动脉压(MAP),记录两组诱导和手术全程的异丙酚用量、诱导时间、手术结束至拔管时间,记录复苏期间及24 h不良反应发生情况等数据并进行统计学处理分析。结果:两组均顺利完成手术。T4时B组心率明显快于A组(P<0.01),其他时间点两组HR与MAP均无差异。两组在T1和T4时心率均增快(P<0.05),B组T4时MAP升高;A组在T3时MAP低于T0。A组诱导期异丙酚用量及诱导时间均小。两组术程异丙酚总量和复苏时间无差别。两组复苏期均未发生呼吸抑制,B组烦躁的发生率较A组高。两组术后随访均未见并发症。结论:NT系统对于气管插管静脉复合全麻下行小儿唇腭裂手术有较好的指导意义,为麻醉医生维持适当的麻醉深度提供直观可靠的指标,有利于麻醉期间患儿安全和生命体征稳定。Objective：To observe the application value of Narcotrend-compact（NT） in depth of anesthesia moni taring during the surgical repair of cleft lip and palate with general anesthesia by endotracheal intubation in children.Methods：Forty children aged 0-7 years scheduled for the surgical repair of cleft lip and palate under general anesth esia with endotracheal intubation were randomly assigned to two groups for varied purposes：treatment group（group A） and control group（group B）,with 20 cases in each group.When the propofol dosage adjustment,the group A received NT monitoring,while the group B received routine monitoring alone by the guidance of senior anesthetist and the changes in vital signs.The heart rate（HR） and mean arterial pressure（MAP） were com pared between the two groups when the patient entered the operation room（T0）,after tracheal intubation（T1）,at the beginning of operation（T2）,at the end of the operation（T3） and after tracheal extubation（T4）.All patie nts record the dosage of propofol during anesthesia induction,the induction time,dosage of propofol during the operation,duration from the operation end to tracheal extubation and adverse reactions occur in the recovery and 24 hours after the operation.Results：The HR and MAP were increased during stages of T1 and T4.The HR was significantly higher in group B than in group A（P〈0.01） during stage of T4,but the MAP was only elevated increasing.The MAP in group A were lower than group B during stages of T3 than TO.The MAP were no sign ificant difference between the two groups in other stages（P〉0.05）.The consumed dose of propofol and induction time in group A were decreased compared to those in group B during induction period,but the doses of propofol and recovery time were the same for both groups.Although all the patients did not occurs respiratory depression symptoms during stages of anesthetic recovery,the restlessness rate was higher in group B than in group A.No obvious postoperative complications

关 键 词：麻醉意识深度监测 小儿 唇腭裂修复术 异丙酚 

分 类 号：R614.24[医药卫生—麻醉学]