肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2012年
9期
620-621,624
,共3页
Narcotrend%丙泊酚%效应室浓度%静脉麻醉%喉罩
Narcotrend%丙泊酚%效應室濃度%靜脈痳醉%喉罩
Narcotrend%병박분%효응실농도%정맥마취%후조
Narcotrend%Propofol%Effect compartment concentrate%Intravenous anesthesia%Laryngeal mask
目的 观察Narcotrend(NT)麻醉深度监测仪在妇科丙泊酚喉罩全静脉麻醉手术中的应用,探讨其对置入喉罩时机和患者意识恢复的预测效果.方法 选择30例按美国麻醉师协会(ASA)分级Ⅰ级的行丙白酚静脉麻醉喉罩插管的妇科手术患者,采用Graseby3500-TCI模式,NT监测麻醉深度,用ZEUS麻醉机的自动控制模式控制呼吸,观察患者在入睡、置入喉罩、停药、自主呼吸、睁眼时的NT值(NTI)、NT分级(NTS)、丙泊酚效应室浓度(Ce)和血流动力学指标.术后随访有无术中知晓情况.结果 患者插入喉罩时与入睡时相比,NTI(77±23比30±9)(Z=5.561,P=0.001)、Ce[(1.1 ±0.4)μg/ml比(2.2±0.4) μg/ml](Z=6.38,P=0.006)、平均动脉压(MAP)[(92±14) mm Hg(1 mm Hg=0.133 kPa)比(83±14)mm Hg](t=2.490,P=0.016)、心率(HR)[(74±l5)次/min比(65±10)次/min](t=2.688,P=0.009)的差异有统计学意义.患者自主呼吸恢复时与停药时相比,NTI(37±7比71±14)差异有统计学意义(Z=6.34,P=0.005).患者睁眼时与停药时相比,NTI(37±7比83±13)(Z=6.668,P=0.003)、Ce [(3.1 ±0.4)μg/ml比(1.6±0.2) μg/ml](Z=6.414,P=0.002)、HR[(59±7)次/min比(64±8)次/min](t=-2.825,P=0.006)的差异有统计学意义.术后随访患者无术中知晓.结论 NT麻醉深度监测仪能有效地指导妇科全静脉麻醉手术中喉罩的置入和拔除.
目的 觀察Narcotrend(NT)痳醉深度鑑測儀在婦科丙泊酚喉罩全靜脈痳醉手術中的應用,探討其對置入喉罩時機和患者意識恢複的預測效果.方法 選擇30例按美國痳醉師協會(ASA)分級Ⅰ級的行丙白酚靜脈痳醉喉罩插管的婦科手術患者,採用Graseby3500-TCI模式,NT鑑測痳醉深度,用ZEUS痳醉機的自動控製模式控製呼吸,觀察患者在入睡、置入喉罩、停藥、自主呼吸、睜眼時的NT值(NTI)、NT分級(NTS)、丙泊酚效應室濃度(Ce)和血流動力學指標.術後隨訪有無術中知曉情況.結果 患者插入喉罩時與入睡時相比,NTI(77±23比30±9)(Z=5.561,P=0.001)、Ce[(1.1 ±0.4)μg/ml比(2.2±0.4) μg/ml](Z=6.38,P=0.006)、平均動脈壓(MAP)[(92±14) mm Hg(1 mm Hg=0.133 kPa)比(83±14)mm Hg](t=2.490,P=0.016)、心率(HR)[(74±l5)次/min比(65±10)次/min](t=2.688,P=0.009)的差異有統計學意義.患者自主呼吸恢複時與停藥時相比,NTI(37±7比71±14)差異有統計學意義(Z=6.34,P=0.005).患者睜眼時與停藥時相比,NTI(37±7比83±13)(Z=6.668,P=0.003)、Ce [(3.1 ±0.4)μg/ml比(1.6±0.2) μg/ml](Z=6.414,P=0.002)、HR[(59±7)次/min比(64±8)次/min](t=-2.825,P=0.006)的差異有統計學意義.術後隨訪患者無術中知曉.結論 NT痳醉深度鑑測儀能有效地指導婦科全靜脈痳醉手術中喉罩的置入和拔除.
목적 관찰Narcotrend(NT)마취심도감측의재부과병박분후조전정맥마취수술중적응용,탐토기대치입후조시궤화환자의식회복적예측효과.방법 선택30례안미국마취사협회(ASA)분급Ⅰ급적행병백분정맥마취후조삽관적부과수술환자,채용Graseby3500-TCI모식,NT감측마취심도,용ZEUS마취궤적자동공제모식공제호흡,관찰환자재입수、치입후조、정약、자주호흡、정안시적NT치(NTI)、NT분급(NTS)、병박분효응실농도(Ce)화혈류동역학지표.술후수방유무술중지효정황.결과 환자삽입후조시여입수시상비,NTI(77±23비30±9)(Z=5.561,P=0.001)、Ce[(1.1 ±0.4)μg/ml비(2.2±0.4) μg/ml](Z=6.38,P=0.006)、평균동맥압(MAP)[(92±14) mm Hg(1 mm Hg=0.133 kPa)비(83±14)mm Hg](t=2.490,P=0.016)、심솔(HR)[(74±l5)차/min비(65±10)차/min](t=2.688,P=0.009)적차이유통계학의의.환자자주호흡회복시여정약시상비,NTI(37±7비71±14)차이유통계학의의(Z=6.34,P=0.005).환자정안시여정약시상비,NTI(37±7비83±13)(Z=6.668,P=0.003)、Ce [(3.1 ±0.4)μg/ml비(1.6±0.2) μg/ml](Z=6.414,P=0.002)、HR[(59±7)차/min비(64±8)차/min](t=-2.825,P=0.006)적차이유통계학의의.술후수방환자무술중지효.결론 NT마취심도감측의능유효지지도부과전정맥마취수술중후조적치입화발제.
Objective To evaluate the predictive effects of Narcotrend(NT) monitor on laryngeal mask intubation and consciousness recovery in propofol-laryngeal mask total intravenous anesthesia of gynecilogical surgery.Methods Thirty ASA I patients undergoing elective gynecilogical surgery under general anesthesia with laryngeal mask intubation were anesthetized with propofol by target-controlled infusion (TCI).NT monitor was used to monitor the anesthesia depth.The ventilation was used on the closed circuit breathing mode of ZEUS anesthesia machine.The values of NT stage (NTS),NT index (NTI),the effect compartment concentration (Ce) and hemodynamic parameters were recorded during the time of sleeping,laryngeal mask intubation,propofol stopping pumping,recovery of spontaneous respiration and eyes opening.The incidence rate of intraoperative awareness was recorded.Results The NTI (77±23,30±9) (Z =5.561,P =0.001),Ce [(1.1±0.4) μg/ml vs (2.2±0.4) μg/ml] (Z=6.38,P=0.006),MAP [(92±14) mm Hg (1 mm Hg =0.133 kPa)vs (83±14) mm Hg] (t =2.490,P =0.016) and HR [(74±15) bpm vs (65±10) bpm] (t =2.688,P =0.009) of the time of intubation were significantly decreased compared to the time of sleeping.The NTI (37±7 vs 71±14)of the time of recovery of spontaneous respiration was significantly increased compared to the time of propofol stopping pumping (Z =6.34,P =0.005).The NTI (37±7 vs 83±13) (Z =6.668,P =0.003),Ce [(3.1±0.4) μg/ml vs (1.6±0.2) μg/ml] (Z =6.414,P =0.002) and HR[(59±7) bpm vs (64±8) bpm] (t =-2.825,P =0.006) of the time of eyes opening were statistically significant compared to the time of propofol stopping pumping.None of patients experienced intraoperative awareness.Conclusion NT monitor can effectively guide the intubation and extubation of laryngeal mask in total intravenous anesthesia of gynecilogical surgery.
