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
2013年
8期
699-702
,共4页
Narcotrend指数%喉罩%老年患者%纤支镜检查
Narcotrend指數%喉罩%老年患者%纖支鏡檢查
Narcotrend지수%후조%노년환자%섬지경검사
Narcotrend index%Laryngeal mask%Elderly%Flexible fiberoptic bronchoscopy
目的 观察Narcotrend在老年人喉罩全麻纤支镜检查中应用的可行性,寻求检查中最适宜的Narcotrend指数(narcotrend index,NTI). 方法 60例择期行喉罩全麻纤支镜检查的老年患者,采用随机数字表法分为3组(每组20例),其中Ⅰ组:NTI(79～65)组、Ⅱ组:NTI(64～37)组、Ⅲ组:NTI(＜37)组,监测各时间点的NTI、无创收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、平均动脉压(mean arterial pressure,MAP)、血氧饱和度(blood oxygen saturation,SpO2)、心率(heart rate,HR)和呼气末二氧化碳分压(end-tidal carbon dioxide partial pressure,PETCO2);记录置喉罩后达到靶NTI的时间及丙泊酚用量、苏醒时间、定向力恢复时间、副作用等. 结果 置喉罩后丙泊酚用量Ⅰ组(2.16±0.31) mg/kg、Ⅱ组(2.78-0.37) mg/kg、Ⅲ组(3.15±0.29)mg/kg,组间差异有统计学意义(P＜0.05).Ⅰ组进镜顺利率为85％,其余两组为100％.各组间SBP、DBP、MAP和HR差异有统计学意义(P＜0.05),且Ⅲ组有2例患者出现低血压及心动过缓.Ⅲ组苏醒时间及定向力恢复时间较Ⅰ组和Ⅱ组延长(P＜0.05). 结论 Narcotrend可监测老年患者麻醉镇静深度,指导调控丙泊酚用量,老年患者喉罩全麻纤支镜检查的适宜NTI为64～37.
目的 觀察Narcotrend在老年人喉罩全痳纖支鏡檢查中應用的可行性,尋求檢查中最適宜的Narcotrend指數(narcotrend index,NTI). 方法 60例擇期行喉罩全痳纖支鏡檢查的老年患者,採用隨機數字錶法分為3組(每組20例),其中Ⅰ組:NTI(79～65)組、Ⅱ組:NTI(64～37)組、Ⅲ組:NTI(＜37)組,鑑測各時間點的NTI、無創收縮壓(systolic blood pressure,SBP)、舒張壓(diastolic blood pressure,DBP)、平均動脈壓(mean arterial pressure,MAP)、血氧飽和度(blood oxygen saturation,SpO2)、心率(heart rate,HR)和呼氣末二氧化碳分壓(end-tidal carbon dioxide partial pressure,PETCO2);記錄置喉罩後達到靶NTI的時間及丙泊酚用量、囌醒時間、定嚮力恢複時間、副作用等. 結果 置喉罩後丙泊酚用量Ⅰ組(2.16±0.31) mg/kg、Ⅱ組(2.78-0.37) mg/kg、Ⅲ組(3.15±0.29)mg/kg,組間差異有統計學意義(P＜0.05).Ⅰ組進鏡順利率為85％,其餘兩組為100％.各組間SBP、DBP、MAP和HR差異有統計學意義(P＜0.05),且Ⅲ組有2例患者齣現低血壓及心動過緩.Ⅲ組囌醒時間及定嚮力恢複時間較Ⅰ組和Ⅱ組延長(P＜0.05). 結論 Narcotrend可鑑測老年患者痳醉鎮靜深度,指導調控丙泊酚用量,老年患者喉罩全痳纖支鏡檢查的適宜NTI為64～37.
목적 관찰Narcotrend재노년인후조전마섬지경검사중응용적가행성,심구검사중최괄의적Narcotrend지수(narcotrend index,NTI). 방법 60례택기행후조전마섬지경검사적노년환자,채용수궤수자표법분위3조(매조20례),기중Ⅰ조:NTI(79～65)조、Ⅱ조:NTI(64～37)조、Ⅲ조:NTI(＜37)조,감측각시간점적NTI、무창수축압(systolic blood pressure,SBP)、서장압(diastolic blood pressure,DBP)、평균동맥압(mean arterial pressure,MAP)、혈양포화도(blood oxygen saturation,SpO2)、심솔(heart rate,HR)화호기말이양화탄분압(end-tidal carbon dioxide partial pressure,PETCO2);기록치후조후체도파NTI적시간급병박분용량、소성시간、정향력회복시간、부작용등. 결과 치후조후병박분용량Ⅰ조(2.16±0.31) mg/kg、Ⅱ조(2.78-0.37) mg/kg、Ⅲ조(3.15±0.29)mg/kg,조간차이유통계학의의(P＜0.05).Ⅰ조진경순리솔위85％,기여량조위100％.각조간SBP、DBP、MAP화HR차이유통계학의의(P＜0.05),차Ⅲ조유2례환자출현저혈압급심동과완.Ⅲ조소성시간급정향력회복시간교Ⅰ조화Ⅱ조연장(P＜0.05). 결론 Narcotrend가감측노년환자마취진정심도,지도조공병박분용량,노년환자후조전마섬지경검사적괄의NTI위64～37.
Objective To observe the feasibility of Narcotrend for aged patients undergoing flexible fiberoptic bronchoscopy with laryngeal mask airway anesthesia and to explore the optimal Narcotrend index (NTI) in the operation.Methods Sixty aged patients were equally randomized into three groups:(Ⅰ)NTI(79-65),(Ⅱ)NTI(64-37) and (Ⅲ)NTI(＜37).Integral dose of propofol after inserting LMA,awakening and orientation recovery time and adverse effects were recorded.NTI,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),blood oxygen saturation(SpO2),heart rate(HR) and end-tidal carbon dioxide partial pressure(PETCO2) were compared in three groups at different time points.Results The doses of propofol were(2.16± 0.31),(2.78±0.37),(3.15±0.29) mg/kg,respectively,in three groups.The successful rate of fiberoptic bronchoscopy insertion was 85％,100％ and 100％,respectively.SBP,DBP,MAP and HR had significant differences among groups(P＜0.05) and hypotension and bradycardia occurred in two patients in Ⅲ group.Awakening and orientation recovery time were longer in Ⅲ group than the other two groups (P＜0.05).Conclusions Narcotrend may monitor the anesthesia sedative depth,direct the regulation of propofol dose,and the optimal NTI for the aged patients undergoing fiberoptic bronchoscopy with laryngeal mask airway anesthesia is 64-37.
