Narcotrend麻醉深度监测下控制性降压在鼻内窥镜手术中的应用研究  

Application of Controlled Hypotension under Narcotrend Anesthesia Depth Monitoring in Endoscopic Nasal Surgery

作　　者：张庆超[1] ZHANG Qingchao(Department of Anesthesiology,Peixian People's Hospital,Peixian,Jiangsu Province,221600 China)

机构地区：[1]沛县人民医院麻醉科,江苏沛县221600

出　　处：《中外医疗》2022年第9期1-4,18,共5页China & Foreign Medical Treatment

摘　　要：目的探讨Narcotrend麻醉深度监测下控制性降压在鼻内窥镜手术中的应用效果。方法随机选取该院2020年1月—2021年8月在该院行鼻内窥镜手术治疗的患者80例,按照抽签法随机分组,其中研究组40例,对照组40例。研究组给予Narcotrend麻醉深度监测下控制性降压,对照组不给予Narcotrend麻醉深度监测下控制性降压,对两组患者麻醉前(T0)、术中降压10 min(T1)、术中降压30 min(T2)、结束手术时(T3)、术毕拔管后(T4)各时间点平均动脉压(MAP)、心率(HR)进行观察记录,同时观察并对比两组患者术中药物用量、手术时间、出血量、术毕至拔管时间。结果在T0、T1、T2、T3、T4各时间点,研究组与对照组MAP对比差异无统计学意义(P>0.05);在T0、T3、T4各时间点,研究组与对照组HR对比差异无统计学意义(P>0.05);在T1、T2时间点,研究组HR分别为(90.31±6.95)、(87.91±6.88)次/min,明显高于对照组,差异有统计学意义(t=6.130、3.926,P<0.05)。研究组瑞芬太尼、丙泊酚用量分别为(495.24±32.66)μg、(201.21±13.08)mg,明显少于对照组,硝酸甘油用量为(6.52±1.16)mg,明显多于对照组,差异有统计学意义(t=10.235、23.508、11.637,P<0.05)。研究组与对照组手术时间、出血量比较差异无统计学意义(P>0.05);研究组术毕至拔管时间为(29.32±3.03)min,明显短于对照组,差异有统计学意义(t=11.838,P<0.05)。结论在鼻内窥镜手术中应用Narcotrend麻醉深度监测下控制性降压,能够有效减少术中麻醉药物用量,加快术后恢复,具有非常高的临床应用价值。Objective To investigate the application effect of controlled hypotension under the deep monitoring of Narcotrend anesthesia in endoscopic nasal surgery.Methods Randomly selected 80 patients who underwent nasal endoscopic surgery in the hospital from January 2021 to August 2021 and were randomly divided into groups according to the lottery method,of which 40 were the study group and 40 were the control group.The study group was given controlled blood pressure under Narcotrend anesthesia depth monitoring,while the control group was not given controlled blood pressure under Narcotrend anesthesia depth monitoring.The mean arterial pressure(MAP)and heart rate(HR)at each time point were observed and recorded before anesthesia(T0),intraoperative hypotension(T1)for 10min(T2),intraoperative hypotension(T2)for 30min(T2),at the end of surgery(T3),and after catheterization(T4).At the same time,the intraoperative drug dosage,operation time,blood loss and extubation time of patients in the two groups were observed and compared.Results At each time point of T0,T1,T2,T3 and T4,there was no statistically significant difference in MAP between the study group and the control group(P>0.05).At each time point of T0,T3 and T4,there was no statistically significant difference in HR between the study group and the control group(P>0.05).At the time point of T1 and T2,the HR of the study group were(90.31±6.95)times/min and(87.91±6.88)times/min,which were significantly higher than those of the control group,the difference was statistically significant(t=6.130,3.926,P<0.05).The dosages of remifentanil and propofol in the study group were(495.24±32.66)μg and(201.21±13.08)mg,respectively,which were significantly lower than those in the control group,and the dosage of nitroglycerin was(6.52±1.16)mg,which was significantly greater than that in the control group,the difference was statistically significant(t=10.235,23.508,11.637,P<0.05).There was statisticaly no significant difference in operation time and blood loss between the study gro

关 键 词：鼻内窥镜手术 Narcotrend麻醉深度监测 控制性降压 心率 平均动脉压 

分 类 号：R765[医药卫生—耳鼻咽喉科]