熵指数联合肌松监测在老年病人全麻诱导期的应用  

Application value of the entropy index combined with muscle relaxation monitoring in induction period of general anesthesia in elderly patients

作　　者：陈琴[1] 赵其宏[1] 程向阳[1] 张运淳[1] CHEN Qin;ZHAO Qi-hong;CHENG Xiang-yang;ZHANG Yun-chun(Department of Anesthesiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院麻醉科

出　　处：《蚌埠医学院学报》2019年第10期1325-1328,共4页Journal of Bengbu Medical College

摘　　要：目的:观察熵指数联合肌松监测在老年全麻诱导期的临床应用效果。方法:择期上腹部手术病人60例,美国麻醉医师协会(ASA)分级Ⅱ~Ⅲ级。用随机数字表法将病人分为Ⅰ、Ⅱ、Ⅲ组,每组20例,分别为熵指数监测联合肌松监测组(Ⅰ组)、熵指数监测(Ⅱ组)、常规监测组(Ⅲ组)。观察并记录3组在麻醉前(T0)、诱导后(T1)、气管插管即刻(T2)、气管插管后1 min(T 3)、气管插管后5 min(T4)时的收缩压、舒张压和心率;3组肌松药推注完毕到气管插管的时间。结果:与Ⅲ组相比,Ⅰ、Ⅱ组在T2、T3时的收缩压与心率相比波动较小(P<0.05~P<0.01)。在T 2、T 3时Ⅱ组的收缩压和心率与Ⅰ组相比波动较大(P<0.05~P<0.01),在T4时Ⅰ、Ⅱ组的收缩压和心率差异均无统计学意义(P>0.05)。Ⅲ组在T2、T3时的收缩压和心率与T0、T1时比较,升高较明显(P<0.05~P<0.01),而Ⅰ、Ⅱ组则变化较小(P<0.05~P<0.01)。3组不同时点的舒张压之间差异均无统计学意义(P>0.05)。3组肌松药推注完毕到气管插管的时间比较,Ⅰ组最长,Ⅱ组次之,Ⅲ组最短(P<0.05~P<0.01)。结论:熵指数联合肌松监测老年病人全麻诱导期的血流动力学维持比较平稳,气管插管条件和声门暴露程度较好。Objective:To observe the application effects of entropy index combined with muscle relaxation monitoring in induction period of general anesthesia in elderly patients.Methods:Sixty patients scheduled by upper abdominal surgery were divided into the muscle relaxant monitoring group(groupⅠ),entropy index monitoring group(groupⅡ)and routine monitoring group(groupⅢ)according to“American Society of anesthesiologists(ASA)gradeⅡtoⅢ”using the random number table method(20 cases each group).The systolic pressure,diastolic pressure,heart rate and time from finishing muscle relaxant injection to tracheal intubation in three groups were recorded before anesthesia(T 0),after induction(T 1),tracheal intubation(T 2),after 1 min of intubation(T 3)and after 5 min of intubation(T 4).Results:Compared with the groupⅢ,the increasing degrees of systolic pressure and heart rate in groupⅠand groupⅡat T 2 and T 3 were less(P<0.05 to P<0.01).Compared with the groupⅠ,the increasing degrees of systolic pressure and heart rate in groupⅡat T 2 and T 3 were more(P<0.05),and the differences of the systolic pressure and heart rate between groupⅠand groupⅡat T 4were not statistically significant(P>0.05).Compared with groupⅢat T 0 and T 1,the increasing degrees of systolic pressure and heart rate were significant at T2 and T3(P<0.05 to P<0.01).Among the three groups,the differences of the diastolic blood pressure at different time points were not statistically significant(P>0.05).The duration from finishing muscle relaxant injection to tracheal intubation in groupⅠ,groupⅡand groupⅢgradually decreased(P<0.05 to P<0.01).Conclusions:The monitoring of entropy index combined with muscle relaxation during general anesthesia induction period in elderly patients can maintain the smooth of hemodynamics,and the tracheal intubation condition and degree of glottis exposure are better.

关 键 词：全身麻醉 肌松监测 熵指数 

分 类 号：R614.2[医药卫生—麻醉学]