国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
4期
305-308
,共4页
Narcotrend%老年人%小肠镜%异丙酚
Narcotrend%老年人%小腸鏡%異丙酚
Narcotrend%노년인%소장경%이병분
Narcotrend%The elderly%Small intestinal enteroscopy%Propofol
目的 观察以Narcotrend脑电监测下调整异丙酚靶控输注浓度的方法用于老年人经肛小肠镜检查的效果.方法 选择40例美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级在全麻下行经肛小肠镜检查的老年患者,采用随机数字表法随机分为试验组和对照组,每组20例.以异丙酚靶控输注进行麻醉,试验组在Narcotrend脑电监测下调整靶浓度,维持麻醉深度于C2水平,对照组依据改良镇静/警醒评分(modified observer assessment of alertness/sedation scale,MOAA/S)评分调整靶浓度,以维持MOAA/S于2分水平.观察两组血流动力学变化情况、异丙酚用量、苏醒时间、副作用、患者及胃肠镜医师满意度. 结果 两组患者平均动脉压、心率、呼吸频率的变化类似,与对照组比较,试验组异丙酚用量减少[试验组(0.068±0.004) mg·kg1·min-1,对照组(0.088±0.005) mg·kg-1 ·min-1,P＜0.05],苏醒时间缩短[试验组(13±4) min,对照组(18±5) min,P＜0.05],胃肠镜医师满意度增高[试验组(3.0±0.0),对照组(2.8±0.4),P＜0.05],两组副作用发生率差异无统计学意义. 结论 在老年人经肛小肠镜检查的麻醉中,以Narcotrend脑电监测指引调整异丙酚靶控输注浓度的麻醉方法可以减少异丙酚用量,缩短苏醒时间,提高胃肠镜医师满意度.
目的 觀察以Narcotrend腦電鑑測下調整異丙酚靶控輸註濃度的方法用于老年人經肛小腸鏡檢查的效果.方法 選擇40例美國痳醉醫師協會(ASA)分級Ⅰ或Ⅱ級在全痳下行經肛小腸鏡檢查的老年患者,採用隨機數字錶法隨機分為試驗組和對照組,每組20例.以異丙酚靶控輸註進行痳醉,試驗組在Narcotrend腦電鑑測下調整靶濃度,維持痳醉深度于C2水平,對照組依據改良鎮靜/警醒評分(modified observer assessment of alertness/sedation scale,MOAA/S)評分調整靶濃度,以維持MOAA/S于2分水平.觀察兩組血流動力學變化情況、異丙酚用量、囌醒時間、副作用、患者及胃腸鏡醫師滿意度. 結果 兩組患者平均動脈壓、心率、呼吸頻率的變化類似,與對照組比較,試驗組異丙酚用量減少[試驗組(0.068±0.004) mg·kg1·min-1,對照組(0.088±0.005) mg·kg-1 ·min-1,P＜0.05],囌醒時間縮短[試驗組(13±4) min,對照組(18±5) min,P＜0.05],胃腸鏡醫師滿意度增高[試驗組(3.0±0.0),對照組(2.8±0.4),P＜0.05],兩組副作用髮生率差異無統計學意義. 結論 在老年人經肛小腸鏡檢查的痳醉中,以Narcotrend腦電鑑測指引調整異丙酚靶控輸註濃度的痳醉方法可以減少異丙酚用量,縮短囌醒時間,提高胃腸鏡醫師滿意度.
목적 관찰이Narcotrend뇌전감측하조정이병분파공수주농도적방법용우노년인경항소장경검사적효과.방법 선택40례미국마취의사협회(ASA)분급Ⅰ혹Ⅱ급재전마하행경항소장경검사적노년환자,채용수궤수자표법수궤분위시험조화대조조,매조20례.이이병분파공수주진행마취,시험조재Narcotrend뇌전감측하조정파농도,유지마취심도우C2수평,대조조의거개량진정/경성평분(modified observer assessment of alertness/sedation scale,MOAA/S)평분조정파농도,이유지MOAA/S우2분수평.관찰량조혈류동역학변화정황、이병분용량、소성시간、부작용、환자급위장경의사만의도. 결과 량조환자평균동맥압、심솔、호흡빈솔적변화유사,여대조조비교,시험조이병분용량감소[시험조(0.068±0.004) mg·kg1·min-1,대조조(0.088±0.005) mg·kg-1 ·min-1,P＜0.05],소성시간축단[시험조(13±4) min,대조조(18±5) min,P＜0.05],위장경의사만의도증고[시험조(3.0±0.0),대조조(2.8±0.4),P＜0.05],량조부작용발생솔차이무통계학의의. 결론 재노년인경항소장경검사적마취중,이Narcotrend뇌전감측지인조정이병분파공수주농도적마취방법가이감소이병분용량,축단소성시간,제고위장경의사만의도.
Objective To observe the effect of Narcotrend-guided target-controlled infusion of propofol in the double balloon enteroscopy in the elderly.Methods Forty ASA Ⅰ-Ⅱ,aged 65-75 patients undergoing double balloon enteroscopy (per anal) were randomized into two groups:target-controlled infusion of propofol guided by narcotrend level (NT group) or modified observer's assessment of alertness/sedation score (MOAA/S)(control group).In NT group,the target concentration of propofol was adjusted to achieve C2 level.In control group,the target concentration was adjusted achieve MOAA/S score of 2.Hemodynamic parameters,drug consumption,recovery time,adverse reactions,patient's and endoscopist's evaluation of satisfaction were recorded.Results Hemodynamic parameters are similar in both groups.In NT group,the consumption of propofol was less [(0.068±0.004) mg· kg-1· min-1vs (0.088±0.005) mg·kg-1·min-1,P＜0.05],recovery time was shorter [(13±4) min vs (18±5) min,P＜0.05] and the endoscopist's satisfaction was higher [(3.0±0.0) vs (2.8±0.4),P＜0.05].There is no significant difference in adverse reactions in both groups.Conclusions Narcotrend-guided anesthesia of propofol leads to less consumption of anesthetics,shorter recovery time and higher endoscopist satisfaction during double balloon enteroscopy in the elderly.
