Narcotrend麻醉深度监测在无痛小肠镜检查中的应用.pdf

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1、第l9卷第2期中国内镜杂志Vo1．19No．22013年2月ChinaJournalofEndoscopyFeb．2O13文章编号：1007—1989(2013)02—0135—04·论著·Narcotrend麻醉深度监测在无痛小肠镜检查中的应用农丽丹，李海风，孙怡(广东省人民医院麻醉科，广东广州510080)摘要：目的探讨NarCOtrend(NT)麻醉深度监测在无痛小肠镜检查丙泊酚一芬太尼全凭静脉麻醉中的应用。方法4()例行经口小肠镜检查的患者，随机分为两组：Narcotrend组和临床组，每组2O例。两组患

2、者均接受异丙酚一芬太尼全凭静脉麻醉。Narcotrend组患者术中根据Narcotrend值(NI)维持在D2～E0调节麻醉深度，临床组患者根据心率、血压及患者体动调节麻醉深度。分别记录两组患者的血流动力学、清醒时间、定向力恢复时间、异丙酚和芬太尼用量及术后患者的恶心呕吐发生率。结果两组患者相对应时段的血流动力学变化差异无显著性(P>O．05)；Narcotrend组患者丙泊酚用量比临床组减少，苏醒时间和定向力恢复时间比临床组缩短，差异有显著性(P<0．05)；两组患者芬太尼用量及恶心呕吐发生率差异无显著性(P>

3、0．05)。结论Nar—cotrend麻醉深度监测在无痛小肠镜检查丙泊酚一芬太尼全凭静脉麻醉中应用有助于减少丙泊酚用量，缩短患者恢复和清醒的时间。关键词：Narcotrend；小肠镜；丙泊酚；芬太尼中图分类号：R614．2文献识别码：AApplication0fnarcotrend-assistedanesthesiain-depth●·●■●‘·■l·monitorinsma儿intestinalenteroscooYNONGLi-dan，LIHai-feng，SUNYi(Department’Anesthes

4、iology,GuangdongGeneralHospital，Guangzhou，Guangdong510080,PR．China)Abstract：【Objective】ToexploretheapplicationofNarcotrend—assistedanesthesiain—depthmonitorinsmallintestinalenteroscopyduringtotalintravenousanesthesiawithpropofolandfentany1．【Methods】40patients

5、ASAI～II，requiringsmallintestinalenteroscopywererandomlydividedintoNarcotrendgroupandclinicalpracticegroup，20patientsineachgroup．Allpatientsreceivedtotalintravenousanesthesiawithpropofolandfentany1．ThepatientsintheNarcotrendgroupwereadjustedanesthesiain——depth

6、accordingtoNarcotrendandNarcotrendindexwasmain—-tainedbetweenD2andE0．Thoseintheclinicalpracticegroupadjustedanesthesiain-depthaccordingtoheartrate，meanarterialpressure，andpatientmovement．Changesofhemodynamiesandthedurationsofemergenceandorien—tationrecoverywe

7、rerecorded．Thedosesofpropofolandfentanyl，andtheincidenceofpostoperativenauseaandvomitingwerealsorecorded．【Results】Therewerenosignificantchangesofheartrateormeanarterialpressurebe—tweentwogroups(P>0．05)．ThedosesofpropofolwerelessintheNarcotrendgroupthaninthecl

8、inicalgroup(P<0．05)．ThedurationsofemergenceandorientationwerelongerintheclinicalgroupthanintheNarcotrendgroup(P<0．05)．Therewerenodifferencesinthedoseoffentany1．andtheincidenceofpostoperat