熵指数在腹腔镜手术全身麻醉深度监测中的应用  

Application of entropy index in depth monitoring of general anesthesia in laparoscopic surgery

作　　者：徐海峰 王开俊[1] 黄龙[1] 闫小辉 XU Haifeng;WANG Kai-jun;HUANG Long(Shenzhen Luohu People’s Hospital,Shenzhen 158000,China)

机构地区：[1]深圳市罗湖区人民医院,158000

出　　处：《中国现代药物应用》2021年第10期78-80,共3页Chinese Journal of Modern Drug Application

摘　　要：目的观察熵指数在腹腔镜手术全身麻醉深度监测中的应用效果。方法60例行全身麻醉下妇科腹腔镜手术患者,按随机数字表法分为对照组和试验组,各30例。两组患者术前均不应用麻醉药物,采用静脉快诱导方法。对照组应用传统方法,记录患者的心率、血压,评估麻醉深度,将麻醉剂量调至最佳;试验组应用熵指数进行评估,主要使反应熵(RE)和状态熵(SE)维持在40~60调节麻醉最佳有效剂量。对比两组患者麻醉药物用量、苏醒时间、拔管时间、拔管后镇静评分(Ramsay)评分及不良反应发生情况。结果试验组地氟烷、瑞芬太尼、舒芬太尼、顺式阿曲库铵用量均明显少于对照组,差异有统计学意义(P<0.05)。试验组苏醒时间(7.5±2.9)min、拔管时间(1.4±0.7)min及Ramsay评分(2.6±0.7)分,均显著低于对照组的(12.9±3.9)min、(3.3±1.5)min及(4.2±1.0)分,差异有统计学意义(P<0.05)。试验组不良反应发生率13.3%明显低于对照组的53.3%,差异有统计学意义(P<0.05)。结论应用熵指数对全身麻醉下行腹腔镜手术患者进行麻醉深度评估,可有效减少麻醉药物的用量,缩短苏醒时间、拔管时间,提高麻醉质量,节省麻醉费用,同时也能减少患者烦躁程度和降低不良反应的发生率。Objective To observe the practical effect of entropy index in depth monitoring of general anesthesia in laparoscopic surgery.Methods A total of 60 cases of gynecological laparoscopic surgery under general anesthesia were divided into control group and experimental group according to random numerical table,with 30 cases in each group.Both groups did not use anesthetics before the operation,and used the intravenous quick induction method.The control group used traditional methods to record the patient’s heart rate and blood pressure,assess the depth of anesthesia,and adjust the anesthesia dose to the best.The experimental group used entropy index evaluation,mainly to maintain the response entropy(RE)and state entropy(SE)between 40 and 60 to adjust the optimal effective dose of anesthesia.The anesthetic dosage,wake-up time,extubation time,Ramsay score after extubation and occurrence of adverse reactions were compared between the two groups.Results The dosage of desflurane,remifentanil,sufentanil,cis-atracurium of the experimental group were obviously less than those of the control group,and the difference was statistically significant(P<0.05).The wakeup time(7.5±2.9)min,extubation time(1.4±0.7)min and Ramsay score(2.6±0.7)points of the experimental group were significantly lower than(12.9±3.9)min,(3.3±1.5)min and(4.2±1.0)points of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions of the experimental group was 13.3%,which was obviously lower than 53.3%of the control group,and the difference was statistically significant(P<0.05).Conclusion The application of entropy index to regulate the depth of anesthesia during laparoscopic surgery under general anesthesia can reduce the anesthetic dosage,shorten wake-up time and extubation time,improve the quality of anesthesia and save anesthesia cost.At the same time it can also reduce the irritability degree and lower the incidence of adverse reactions.

关 键 词：熵指数 腹腔镜手术 全身麻醉 麻醉监测 

分 类 号：R614[医药卫生—麻醉学]