东南国防医药
東南國防醫藥
동남국방의약
JOURNAL OF SOUTHEAST CHINA NATIONAL DEFENCE MEDICAL SCIENCE
2014年
6期
575-577
,共3页
余志阳%郑大东%刘清珍%徐苗苗%李伟彦%刘健%朱四海
餘誌暘%鄭大東%劉清珍%徐苗苗%李偉彥%劉健%硃四海
여지양%정대동%류청진%서묘묘%리위언%류건%주사해
Narcotrend%七氟烷%意识%血流动力学
Narcotrend%七氟烷%意識%血流動力學
Narcotrend%칠불완%의식%혈류동역학
Narcotrend%sevoflurane%consciousness%hemodynamic
目的:观察Narcotrend麻醉深度监护仪对硬膜外复合七氟烷吸入麻醉患者苏醒期意识恢复的预测效果。方法40例ASAⅠ~Ⅱ级在硬膜外复合全身麻醉下择期行肠道手术患者,丙泊酚复合苏芬太尼靶控输注诱导,手术期间通过硬膜外镇痛、七氟烷镇静、顺式阿曲库铵肌肉松弛来维持麻醉。手术结束入麻醉恢复室,记录刺激无体动反应( T1)、呼之睁眼(T2)、定向力恢复(T3)时Narcotrend指数(Narcotrend Index,NI)、七氟烷最低肺泡有效浓度(MAC)、平均动脉压(MAP)和心率(HR),通过相关参数计算出上述参数对意识恢复的预测概率(PK)。结果硬膜外复合全身麻醉监测NI值能够预测苏醒期患者意识的改变。 NI预测患者呼之睁眼时PK 值为(0.76±0.07),预测定向力恢复时PK 值为(0.74±0.06),高于0.5(P<0.05),也高于MAP和HR的相应得预测概率PK 值。苏醒期NI值与七氟烷MAC值的变化呈明显的负相关性,相关系数(r)为-0.896(P<0.01)。结论 Narcotrend能有效地反映硬膜外复合全身麻醉下苏醒期患者意识水平的变化,其对苏醒期意识恢复的预测能力显著高于血流动力学指标。
目的:觀察Narcotrend痳醉深度鑑護儀對硬膜外複閤七氟烷吸入痳醉患者囌醒期意識恢複的預測效果。方法40例ASAⅠ~Ⅱ級在硬膜外複閤全身痳醉下擇期行腸道手術患者,丙泊酚複閤囌芬太尼靶控輸註誘導,手術期間通過硬膜外鎮痛、七氟烷鎮靜、順式阿麯庫銨肌肉鬆弛來維持痳醉。手術結束入痳醉恢複室,記錄刺激無體動反應( T1)、呼之睜眼(T2)、定嚮力恢複(T3)時Narcotrend指數(Narcotrend Index,NI)、七氟烷最低肺泡有效濃度(MAC)、平均動脈壓(MAP)和心率(HR),通過相關參數計算齣上述參數對意識恢複的預測概率(PK)。結果硬膜外複閤全身痳醉鑑測NI值能夠預測囌醒期患者意識的改變。 NI預測患者呼之睜眼時PK 值為(0.76±0.07),預測定嚮力恢複時PK 值為(0.74±0.06),高于0.5(P<0.05),也高于MAP和HR的相應得預測概率PK 值。囌醒期NI值與七氟烷MAC值的變化呈明顯的負相關性,相關繫數(r)為-0.896(P<0.01)。結論 Narcotrend能有效地反映硬膜外複閤全身痳醉下囌醒期患者意識水平的變化,其對囌醒期意識恢複的預測能力顯著高于血流動力學指標。
목적:관찰Narcotrend마취심도감호의대경막외복합칠불완흡입마취환자소성기의식회복적예측효과。방법40례ASAⅠ~Ⅱ급재경막외복합전신마취하택기행장도수술환자,병박분복합소분태니파공수주유도,수술기간통과경막외진통、칠불완진정、순식아곡고안기육송이래유지마취。수술결속입마취회복실,기록자격무체동반응( T1)、호지정안(T2)、정향력회복(T3)시Narcotrend지수(Narcotrend Index,NI)、칠불완최저폐포유효농도(MAC)、평균동맥압(MAP)화심솔(HR),통과상관삼수계산출상술삼수대의식회복적예측개솔(PK)。결과경막외복합전신마취감측NI치능구예측소성기환자의식적개변。 NI예측환자호지정안시PK 치위(0.76±0.07),예측정향력회복시PK 치위(0.74±0.06),고우0.5(P<0.05),야고우MAP화HR적상응득예측개솔PK 치。소성기NI치여칠불완MAC치적변화정명현적부상관성,상관계수(r)위-0.896(P<0.01)。결론 Narcotrend능유효지반영경막외복합전신마취하소성기환자의식수평적변화,기대소성기의식회복적예측능력현저고우혈류동역학지표。
Objective To evaluate the predictive effect of Narcotrend on consciousness recovery during the emergence of gen -eral anesthesia combined with epidural block .Methods Forty ASAⅠorⅡpatients undergoing elective bowel surgery were anesthe-tized with general anesthesia combined with epidural block .Anesthesia was induced by target controlled infusion of propofol combined with sufentanil,and maintained by epidural analgesia ,sevoflurane in sedation and cisatracurium in muscle relaxant .After surgery,the patients were transferred to the postanesthesia care unit (PACU),the values of NI (Narcotrend Index),minimum alveolar concentration ( MAC) of sevoflurane ,and hemodynamic parameters ( MAP and HR) were recorded during the period of non-reaction to the stimulation (T1),at the time of eyes opening (T2) and orientation recovery (T3).The prediction probability (PK) of each parameter was calculat-ed.Results NI were correlated well with the changes of consciousness during the emergence of general anesthesia combined with epi -dural block.PK values of NI in predicting eyes opening and orientation recovery were (0.76 ±0.07),(0.74 ±0.06),respectively,and were obviously higher than 0.5 and the PK values of MAP and HR (P<0.01).The values of NI were obvious negative correlated with MAC values of sevoflurane,and correlation coefficient was -0.896 (P<0.01).Conclusion Narcotrend monitor can be effectively used for predicting patients'consciousness recovery during the emergence of general anesthesia combined with epidural block ,however, the ability of prediction with Narcotrend on consciousness recovery was significantly higher than that of hemodynamic parameters .