Narcotrend用于全麻手术期间麻醉深度监测的临床评价

目的: 评价Narcotrend麻醉深度监测仪(NT)用于气管内静吸复合麻醉准确性及实用性.方法: ASA分级Ⅰ或Ⅱ级患者40例,随机均分为2组.观察组,以NT监测数据判断麻醉深度并调整用药;对照组,麻醉医师根据临床经验判断麻醉深度并调整用药.常规监测平均动脉压(MAP)、心电图(ECG)、心率(HR)等,计算用药总量,记录苏醒时间.结果: 观察组在切皮(T₄)、术中(T₅)、术毕(T₆)、出室(T₇)的MAP和HR与对照组比较差异有统计学意义(P<0.05～P<0.01),观察组在T₄、T₆、T₇的NT指数与对照组差异均有统计学意义(P<0.05～P<0.01),对照组在T₆、T₇的NT指数与基础值(T₁)差异均有统计学意义(P<0.01和P<0.05);2组患者丙泊酚、舒芬太尼和七氟烷用量差异均有统计学意义(P<0.01),咪达唑仑用量差异无统计学意义(P>0.05);观察组的苏醒时间和拔管时间均短于对照组(P<0.05);观察组无一例发生术中知晓,对照组有1例发生术中知晓.结论: NT能较好地反映全麻手术患者镇静深度变化,有助于判断全麻深度,指导个体化麻醉用药,提高麻醉质量.

The application of Narcotrend in the monitoring of general anesthesia

Objective： To evaluate the accuracy and practicability of Narcotrend（ NT） in the monitoring of general anesthesia.Methods： Forty patients with grade Ⅰ- ⅡASA were randomly divided into the observation group and control group（ 20 cases each group）. The drug in observation group was adjusted according to the anesthetic depth detected by NT,the drug in control group was adjusted according to the clinical experience. The levels of MAP,ECG and HR were observed,the drug use and awakening time were recorded. Results： The differences of MAP and HR on the time-point of skin incision（ T4）,operating（ T5）,end of surgery（ T6） and going out the operation room（ T7） between observation group and control group were statistically significant（ P 0.05 to P 0.01）. The differences of NT index on the time-point of T4,T6 and T7between observation group and control group were statistically significant（ P〈0.05 to P〈0.01）,the differences of NT index between T6 T7time-point and T1 in control group were statistically significant（ P〈0.05 and P〈0.01）. The differences of the dosage of propofol,sufentanil and sevoflurane between two groups were statistically significant（ P〈0.01）,for the dosage of midazolam,it was not statistically significant（ P〉0.05）. The awakening and extubation time in observation group were shorter than those in control group（ P〈0.05）. No awarenss case in observation group and 1 awareness case with in control group during operation were observed. Conclusions： NT can well reflect the sedation depth of general anesthesia,which can help to judge the depth of anesthesia,guide anesthesia drug use and improve the quality of anesthesia.