Narcotrend监测下复合七氟烷用于妇科腔镜下卵巢癌根治手术效果观察  

Observation on the effect of narcotrend combined with sevoflurane in gynecological laparoscopic radical surgery for ovarian cancer

作　　者：王力峰[1] 张巍 陈丽[1] 邓云菱[1] 王万辉[1] 李晓玲[1] 李雪玫 叶军明[1] Wang Lifeng;Zhang Wei;Chen Li;Deng Yunling;WangWanhui;Li Xiaoling;Li Xuemei;Ye Junming(Department of Anesthesiology,the First Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣南医学院第一附属医院麻醉科,江西赣州341000

出　　处：《当代医学》2020年第27期86-88,共3页Contemporary Medicine

摘　　要：目的探讨Narcotrend复合七氟烷吸入麻醉用于妇科腔镜下卵巢癌根治手术的有效性和安全性。方法选取2016年1月至2017年2月在本院择期行全麻妇科手术患者70例,随机分为A、B组,每组35例。A组根据NI指数调节麻醉深度,B组根据患者心率、血压及经验调节麻醉深度。比较两组气管插管前(T1)、气管插管后即刻(T2)、气腹前2 min(T3)、气腹后5 min(T4)、气腹结束后即刻(T5)、手术结束(T6)的HR、MAP,呼吸末七氟烷浓度(Csevo%),术后听从指令时间、拔管时间,并发症、术中知晓情况以及6个时间点血浆中肾上腺素(AD)、去甲肾上腺素(NA)浓度。结果两组患者各时间点(T1、T2、T3、T4、T5、T6)HR、MAP比较差异均无统计学意义;T2、T3、T4时,A组Csevo%高于B组,差异有统计学意义(P<0.05);T5时,A组Csevo%低于B组,差异有统计学意义(P<0.05);T1、T6时,两组Csevo%比较差异无统计学意义;A组听从指令时间、拔管时间均明显短于B组,比较有统计学意义(P<0.05);A组恶心、呕吐,术后烦躁与B组比较差异无统计学意义;两组患者术后均无术中知晓发生,差异无统计学意义;T1、T2、T6时,两组AD、NA浓度比较差异无统计学意义;T3、T4、T5时,A组AD、NA浓度均低于B组,比较差异有统计学意义(P<0.05)。结论 Narcotrend复合七氟烷吸入麻醉应用于妇科腔镜下卵巢癌根治手术,根据NI数值调节七氟烷,能有效缩短苏醒时间和拔管时间,降低应激反应,提高手术的有效性及安全性。Objective To explore the effectiveness and safety of Narcotrend(NI)combined sevoflurane inhalation anesthesia for radical surgery of ovarian cancer under gynecologic laparoscopy.Methods 70 patients undergoing elective general anesthesia gynecological surgery in our hospital from January 2016 to February 2017 were selected and randomly divided into group A and group B,with 35 cases in each group,all patients underwent surgery under tracheal intubation under general anesthesia.In group A,anesthesia depth was adjusted according to NI index,while in group B,anesthesia depth was adjusted according to heart rate,blood pressure and experience of patients.Compared to before endotracheal intubation(T1),immediately after endotracheal intubation(T2),2 min before pneumoperitoneum(T3),5 min after pneumoperitoneum(T4),pneumoperitoneum(T5),immediately after the end of surgery(T6)HR,MAP,breathing at the end of the concentration of sevoflurane(Csevo%),listen to instruction time,extubation time,postoperative complications,intraoperative awareness and six points in plasma adrenaline(AD),norepinephrine(NA)concentration between two groups.Results There was no statistically significant difference in HR and MAP between the two groups at all time points(T1,T2,T3,T4,T5 and T6).At T2,T3 and T4,Csevo%in group A was higher than that in group B,with statistically significant difference(P<0.05).At T5,Csevo%in group A was lower than that in group B,and the difference was statistically significant(P<0.05).At T1 and T6,there was no statistically significant difference in Csevo%between the two groups.The time of following instructions and extubation in group A was significantly shorter than that in group B(P<0.05).Nausea and vomiting were not significantly different between group A and group B.There was no intraoperative awareness between the two groups,and the difference was not statistically significant.At T1,T2 and T6,the concentrations of AD and NA in the two groups was not statistically significant difference.At T3,T4 and T5,the concentratio

关 键 词：Narcortrend监测 七氟烷 腹腔镜手术 应激反应 

分 类 号：R614[医药卫生—麻醉学] R737.31[医药卫生—外科学]