基于麻醉深度与肌松监测仪监测指导下的麻醉方式在经口腔前庭入路机器人辅助甲状腺切除患者中的应用  

Application of anesthesia guided by anesthetic depth and neuromuscular monitoring in patients undergoing transoral vestibular robot-assisted thyroidectomy

作　　者：白建云 贺峰 贺婷 曹浪浪 郝静 李斌 BAI Jianyun;HE Feng;HE Ting;CAO Langlang;HAO Jing;LI Bin(Department of Anesthesiology,the Third Hospital of Yulin,Yulin 719000,China;Department of Anesthesiology,the First Affiliated Hospital of Xi`an Jiaotong University,Xi`an 710061,China)

机构地区：[1]榆林市第三医院·榆林市传染病医院麻醉科,陕西榆林719000 [2]西安交通大学第一附属医院麻醉科,陕西西安710061

出　　处：《机器人外科学杂志(中英文)》2025年第4期596-600,共5页Chinese Journal of Robotic Surgery

基　　金：榆林市科协计划项目(20220454)。

摘　　要：目的:探讨基于麻醉深度与肌松监测仪监测指导下的麻醉方式在经口腔前庭入路机器人辅助甲状腺切除患者中的应用效果。方法:选取2018年1月—2024年6月榆林市第三医院收治的150例行经口腔前庭入路机器人辅助甲状腺切除术患者作为研究对象。按照随机数表法,将所有患者分为观察组和对照组,每组各75例。观察组给予基于麻醉深度及肌松监测仪监测指导下的麻醉方式,对照组给予常规监测指导下的麻醉方式。比较两组麻醉情况、丙泊酚用量,以及在诱导前(T0)、术中1 h(T1)、手术完成时(T2)、术后6 h(T3)的血流动力学指标和不良反应发生情况。结果:观察组拔管时间、自主呼吸恢复时间及苏醒时间显著低于对照组(P<0.05)。观察组丙泊酚诱导总剂量、诱导阶段及维持阶段丙泊酚输注量均显著低于对照组(P<0.05)。在T1、T2及T3时,观察组HR及MAP均显著低于对照组(P<0.05)。两组患者的不良反应总发生率差异无统计学意义(P>0.05)。结论:基于麻醉深度及肌松监测仪监测指导下的麻醉方式能够有效缩短经口腔前庭入路机器人辅助甲状腺切除术患者的恢复时间,减少术中麻醉药物用量,有助于维持更稳定的血流动力学状态。Objective:To investigate the efficacy of anesthesia guided by anesthetic depth and neuromuscular monitor in patients undergoing transoral robot-assisted thyroidectomy(TORT).Methods:150 patients who underwent robot-assisted thyroidectomy in transoral vestibular the Third Hospital of Yulin from January 2018 to June 2024 were selected.They were divided into the observation group and the control group using a random number table,with 75 patients in each group.The observation group received anesthesia guided by anesthetic depth and neuromuscular monitoring,while the control group received conventional monitoring-guided anesthesia.Anesthesia outcomes,propofol dosage,hemodynamic parameters at pre-induction(T0),1 hour intraoperatively(T1),end of surgery(T2),and 6 hours after surgery(T3),and adverse reactions were compared between the two groups of patients.Results:The extubation time,spontaneous respiration recovery time,and awakening time in the observation group were significantly earlier than those in the control group(P<0.05).The total induction dose of propofol,as well as the propofol infusion doses during induction and maintenance phases,were significantly lower in the observation group than those in the control group(P<0.05).At T1,T2,and T3,heart rate and mean arterial pressure(MAP)in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusion:Anesthesia guided by anesthetic depth and neuromuscular monitoring can effectively shorten recovery time,reduce intraoperative anesthetic dosage,and maintain more stable hemodynamics in patients undergoing TORT.

关 键 词：麻醉深度 肌松监测仪 机器人辅助手术 经口腔前庭入路 甲状腺切除术 

分 类 号：R614[医药卫生—麻醉学] R653[医药卫生—外科学]