中华妇幼临床医学杂志(电子版)
中華婦幼臨床醫學雜誌(電子版)
중화부유림상의학잡지(전자판)
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2014年
4期
507-510
,共4页
黄俊祥%宋兴荣%田航%李碧莲%倪锦
黃俊祥%宋興榮%田航%李碧蓮%倪錦
황준상%송흥영%전항%리벽련%예금
Narcotrend%监测,手术中%麻醉,全身%小儿
Narcotrend%鑑測,手術中%痳醉,全身%小兒
Narcotrend%감측,수술중%마취,전신%소인
Narcotrend%Monitoring,intraoperative%Anesthesia,general%Child
目的:探讨 Narcotrend 麻醉深度监测在小儿全身静脉麻醉中的临床效果。方法选择2013年6月~11月于广州市妇女儿童医疗中心住院治疗的40例择期腹部手术患儿为研究对象,按照入院序号,将其随机分为研究组(n=20)和对照组(n=20)。本研究遵循的程序符合广州市妇女儿童医疗中心人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与之签署临床研究知情同意书。两组患儿均接受丙泊酚-瑞芬太尼全身静脉麻醉,研究组患儿术中接受 Narcotrend麻醉深度监测,对照组患儿术中根据常规临床监测指标调节麻醉深度。监测两组患儿术前、麻醉诱导后、手术开始、手术结束、拔管5个时间点的心率(HR)、平均动脉压(MAP)。记录苏醒时间及拔管时间、丙泊酚和瑞芬太尼的用量及术后不良反应发生率。结果两组患儿5个时间点 H R和 MAP 的变化分别比较,差异均无统计学意义(P>0.05),而研究组患儿全身麻醉中丙泊酚用量、术后苏醒时间及拔管时间均显著小于对照组[(122.71±21.06)mg vs.(181.08±25.97)mg,(4.37±2.05)min vs.(9.15±5.13)min,(6.68±2.32)min vs.(12.45±5.15)min],并且差异有统计学意义(P<0.01)。两组术后无一例患儿出现明显恶心、呕吐等不良反应,术后24 h随访结果显示,均无麻醉并发症发生。结论 Narcotrend 麻醉深度监测有助于减少静脉全身麻醉中丙泊酚用量,缩短患儿术后苏醒时间和拔管时间。
目的:探討 Narcotrend 痳醉深度鑑測在小兒全身靜脈痳醉中的臨床效果。方法選擇2013年6月~11月于廣州市婦女兒童醫療中心住院治療的40例擇期腹部手術患兒為研究對象,按照入院序號,將其隨機分為研究組(n=20)和對照組(n=20)。本研究遵循的程序符閤廣州市婦女兒童醫療中心人體試驗委員會所製定的倫理學標準,得到該委員會批準,分組徵得受試對象鑑護人的知情同意,併與之籤署臨床研究知情同意書。兩組患兒均接受丙泊酚-瑞芬太尼全身靜脈痳醉,研究組患兒術中接受 Narcotrend痳醉深度鑑測,對照組患兒術中根據常規臨床鑑測指標調節痳醉深度。鑑測兩組患兒術前、痳醉誘導後、手術開始、手術結束、拔管5箇時間點的心率(HR)、平均動脈壓(MAP)。記錄囌醒時間及拔管時間、丙泊酚和瑞芬太尼的用量及術後不良反應髮生率。結果兩組患兒5箇時間點 H R和 MAP 的變化分彆比較,差異均無統計學意義(P>0.05),而研究組患兒全身痳醉中丙泊酚用量、術後囌醒時間及拔管時間均顯著小于對照組[(122.71±21.06)mg vs.(181.08±25.97)mg,(4.37±2.05)min vs.(9.15±5.13)min,(6.68±2.32)min vs.(12.45±5.15)min],併且差異有統計學意義(P<0.01)。兩組術後無一例患兒齣現明顯噁心、嘔吐等不良反應,術後24 h隨訪結果顯示,均無痳醉併髮癥髮生。結論 Narcotrend 痳醉深度鑑測有助于減少靜脈全身痳醉中丙泊酚用量,縮短患兒術後囌醒時間和拔管時間。
목적:탐토 Narcotrend 마취심도감측재소인전신정맥마취중적림상효과。방법선택2013년6월~11월우엄주시부녀인동의료중심주원치료적40례택기복부수술환인위연구대상,안조입원서호,장기수궤분위연구조(n=20)화대조조(n=20)。본연구준순적정서부합엄주시부녀인동의료중심인체시험위원회소제정적윤리학표준,득도해위원회비준,분조정득수시대상감호인적지정동의,병여지첨서림상연구지정동의서。량조환인균접수병박분-서분태니전신정맥마취,연구조환인술중접수 Narcotrend마취심도감측,대조조환인술중근거상규림상감측지표조절마취심도。감측량조환인술전、마취유도후、수술개시、수술결속、발관5개시간점적심솔(HR)、평균동맥압(MAP)。기록소성시간급발관시간、병박분화서분태니적용량급술후불량반응발생솔。결과량조환인5개시간점 H R화 MAP 적변화분별비교,차이균무통계학의의(P>0.05),이연구조환인전신마취중병박분용량、술후소성시간급발관시간균현저소우대조조[(122.71±21.06)mg vs.(181.08±25.97)mg,(4.37±2.05)min vs.(9.15±5.13)min,(6.68±2.32)min vs.(12.45±5.15)min],병차차이유통계학의의(P<0.01)。량조술후무일례환인출현명현악심、구토등불량반응,술후24 h수방결과현시,균무마취병발증발생。결론 Narcotrend 마취심도감측유조우감소정맥전신마취중병박분용량,축단환인술후소성시간화발관시간。
Objective To explore the application of Narcotrend-assisted anesthesia in-depth monitor during total intravenous anesthesia in children.Methods From June to November 2013,a total of 40 children who underwent abdominal surgery were included in the study randomly.They were divided into Narcotrend group (n=20)and control group (n=20).All patients received total intravenous anesthesia with propofol and remifentanil.The patients in Narcotrend group adj usted anesthesia in-depth according to Narcotrend index(NTI).Those patients in control group adj usted anesthesia in-depth according to their heart rate(HR),mean arterial pressure(MAP)and movement.Changes of hemodynamics,durations of emergence and tracheal extubation were recorded.The doses of propofol and remifentanil and the incidence rates of postoperative nasea and vomiting were also recorded.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Guangzhou Women and Children′s Medical Center. Informed consent was obtained from each participants′ parents. Results There were no significant differences in HR and MAP at 5 observation time points between two groups (P>0.05 ).The dose of propofol was lower in Narcotrend group than that of control group [(122.71 ± 21.06 ) mg vs. (181.08±25.97)mg,P<0.01].The durations of emergence and tracheal extubation were respectively shorter in Narcotrend group than those of control group [(4.37±2.05)min vs.(9.15±5.13)min, (6.68±2.32)min vs.(12.45±5.15)min;P<0.01].No one had postoperative nausea and vomiting in both groups.Conclusion Narcotrend-assisted anesthesia in-depth monitor can contribute to reduce the dose of propofol and shorten the duration of recovery during total intravenous anesthesia with propofol and remifentanil.