Narcotrend监测在肥胖患者行腹腔镜手术全麻苏醒期的应用  

Application of Narcotrend monitoring in the recovery period of general anesthesia in obese patients undergoing laparoscopic surgery

作　　者：钟瑞蓬 李优春[1] 黄春玲[1] 刘晓成[1] 黄桂明[1] Zhong Ruipeng;Li Youchun;Huang Chunling;Liu Xiaocheng;Huang Guiming(Department of anesthesia,People＇s Hospital of Ganzhou City,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市人民医院麻醉科,江西赣州341000

出　　处：《当代医学》2018年第17期99-101,共3页Contemporary Medicine

基　　金：江西省赣州市科技计划立项课题(GZ2017ZSF181)

摘　　要：目的观察和比较不同体重指数(BMI)患者全麻行腹腔镜手术后苏醒期不同阶段的NI指数(NTI)。探讨Narcotrend监测在肥胖患者行腹腔镜手术全麻苏醒期的应用。方法选择ASAⅠ~Ⅱ级,择期全身麻醉下行腹腔镜手术患者40例,按不同BMI分为两组,N组BMI≤27.9,M组≥28.0。术中以七氟醚联合瑞芬太尼维持麻醉,深度维持在NTI在37~64,术毕停药并送苏醒室。记录麻醉诱导前,麻醉苏醒期对刺激有反应时,定向力恢复清醒时,拔管时,离室时的NI指数(NTI),并记录苏醒时间、拔管迟滞时间、离室时间及拔管后并发症。结果诱导前,对刺激有反应时,定向力恢复清醒时两组间NTI监测结果无统计学意义。在拔管时M组NTI明显低于N组。M组苏醒时间、拔管时间、离室时间明显长于N组,两组拔管迟滞时间无统计学意义。两组拔管及离室后均未出现相关不良反应。结论肥胖患者全麻苏醒时间显著长于正常体质量患者,肥胖患者不需要达到更高的NTI能安全拔管。Objective The NI index（NTI） of patients with different body mass index（BMI） at different stages of recovery from general anesthesia after laparoscopic surgery was observed and compared. To explore the application of Narcotrend monitoring in the recovery period of general anesthesia in obese patients undergoing laparoscopic surgery. Methods 40 patients undergoing laparoscopic operation under general anesthesia were selected and divided into two groups according to ASA BMI grade II. Group N was BMI27.9 and group M was more than 28.0. Sevoflurane and remifentanil were used to maintain anesthesia during operation. The depth was maintained at NTI at 37-64. The NI index（NTI） at the time of extubation and removal of the room was recorded before the induction of anesthesia during the induction of anaesthesia during the awakening period, when the orientation was restored, and the waking time, the time of extubation, the time of leaving the room and the complications after extubation were recorded. Results Before induction, there was no significant difference in NTI monitoring between the two groups when the response of the stimulus was regained consciousness. At the time of extubation, the NTI of group M was significantly lower than that of group N. The recovery time, extubation time and time of leaving the room in group M were significantly longer than those in group N. There was no statistical significance in the time of extubation delay between the two groups. No adverse reactions were found in the two groups after extubation and after leaving the room.Conclusion The recovery time of general anesthesia in obese patients is significantly longer than that in normal weight patients. Obese patients do not need to achieve higher NTI to extubate safely.

关 键 词：Narcotrend监测 肥胖 苏醒期 腹腔镜 

分 类 号：R614[医药卫生—麻醉学]