CAJ | 학술논문

目的：：观察七氟烷吸入麻醉期间Narcotrend指数( NTI)的变化,观测NTI监测麻醉深度的精确性、灵敏性和稳定性。方法：选择ASAⅠ~Ⅱ级、需行气管内插管全麻的腹部手术成年患者90例。入室后监测基础生命体征、NTI值,吸入七氟烷,待患者意识消失后,依次静脉注射舒芬太尼、顺式阿曲库铵后行气管内插管。记录基础值(T0)、插管前(T1)、插管即刻(T2)及插管后3 min(T3)、手术切皮后(T4)、进腹(T5)、停吸七氟烷(T6)、拨管前(T7)、拔管后5 min(T8)各时点NTI及平均动脉压、心率、血糖变化。结果：麻醉诱导过程中随着七氟烷吸入时间的增加,NTI、动脉压、心率均逐渐下降；气管插管、切皮、进入腹腔、麻醉苏醒等刺激强烈步骤时上述体征又上升。与T0比较,T1和T3的NTI明显降低(P<0.01)；T2、T4、 T5与T1比较,NTI均明显升高(P<0.01)。结论：NTI值能准确监测七氟烷吸入麻醉期间麻醉深度的变化,精确判断麻醉诱导期、外科手术期和麻醉苏醒期,指导麻醉医师调控麻醉深度。
목적：：관찰칠불완흡입마취기간Narcotrend지수( NTI)적변화,관측NTI감측마취심도적정학성、령민성화은정성。방법：선택ASAⅠ~Ⅱ급、수행기관내삽관전마적복부수술성년환자90례。입실후감측기출생명체정、NTI치,흡입칠불완,대환자의식소실후,의차정맥주사서분태니、순식아곡고안후행기관내삽관。기록기출치(T0)、삽관전(T1)、삽관즉각(T2)급삽관후3 min(T3)、수술절피후(T4)、진복(T5)、정흡칠불완(T6)、발관전(T7)、발관후5 min(T8)각시점NTI급평균동맥압、심솔、혈당변화。결과：마취유도과정중수착칠불완흡입시간적증가,NTI、동맥압、심솔균축점하강；기관삽관、절피、진입복강、마취소성등자격강렬보취시상술체정우상승。여T0비교,T1화T3적NTI명현강저(P<0.01)；T2、T4、 T5여T1비교,NTI균명현승고(P<0.01)。결론：NTI치능준학감측칠불완흡입마취기간마취심도적변화,정학판단마취유도기、외과수술기화마취소성기,지도마취의사조공마취심도。
Objective:To observe the changes of Narcotrend index( NTI) during sevoflurane inhalation anesthesia,analyze the clinical significance of monitoring the depth of anesthesia using NTI, and explore the accuracy, sensitivity and stability. Methods:Ninety patients(ASA gradeⅠtoⅡ) scheduled by abdominal surgery under general anesthesia through endotracheal intubation were selected. The vital signs and NTI value in the patients were monitored,all cases inhaled sevoflurane. The endotracheal intubation in the patients were implemented following by intravenous injection of sufentanyl and cisatracurium after the consciousness of patients disappeared. The levels of NTI,mean aortic pressure(MAP),heart rate(HR) and blood glucose(Glu) in all cases were recorded at the beginning of induction( T0 ) ,before incubation( T1 ) ,incubation( T2 ) ,after 3 min of intubation( T3 ) ,after cutting skin( T4 ) ,opening abdomen( T5 ) , stopping sevoflurane( T6 ) ,before excubation( T7 ) and after 5 min of excubation( T8 ) . Results:The levels of NTI,MAP and HR dropped gradually with the time prolonging of inhaling sevoflurane,which increased after the stimulation of endotracheal intubation,cutting skin, opening abdomen and anesthesia recovery. Compared with T0,the NTI value at T1 and T3 significantly decreased(P<0. 01). Compared with T1,the NTI value at T2,T4 and T3 significantly increased(P<0. 01). Conclusions:Narcotrend value can accurately monitor the depth of anesthesia during the sevoflurane anesthesia, which can accurately judge the induction period of anesthesia, surgery and anesthesia recovery period to guide the regulation of anesthesia depth.