Narcotrend监测丙泊酚-瑞芬太尼复合麻醉在乳腺癌根治手术中的应用

目的评价Narcotrend监测指导调节麻醉深度对丙泊酚-瑞芬太尼复合麻醉药物用量及麻醉后恢复的影响。方法将择期行丙泊酚-瑞芬太尼复合麻醉下乳腺癌根治切除术成年女性患者60例随机分为2组(每组30例),对照组和Narcotrend监测组(N组)。各组均以瑞芬太尼、丙泊酚及维库溴铵行气管插管下全身麻醉。术中监测心电图、血压及脉搏血氧饱和度。对照组安置Narcotrend监测电极、不行记录,N组持续记录Narcotrend指数。对照组根据临床体征(血压、心率、体动等)调节麻醉深度,N组按维持Narcotrend指数值为D0(N组)调节丙泊酚及瑞芬太尼输注速率。记录睁眼时间和拔管时间并计算术中丙泊酚及瑞芬太尼用量。结果与对照组比较,N组丙泊酚用量减少、睁眼及拔管时间缩短,差异有统计学意义(P0.05),麻醉时间及瑞芬太尼用量差异无统计学意义(P0.05)。结论丙泊酚-瑞芬太尼复合麻醉中,Narcotrend指数指导调节麻醉深度下,丙泊酚用量减少、麻醉恢复迅速;Narcotrend指数能及时有效反映麻醉深度,有利于全身麻醉患者复苏。

The application of Narcotrend monitoring in propofol-remifentanil combined anesthesia in radical operation of breast cancer

Objective To investigate the impact of Narcotrend monitoring on the time needed for recovery from anesthetic in propofol‐remifentanil combined anesthesia .Methods Sixty adult female patients who were scheduled to undergo radical operation of breast cancer with propofol‐remifentanil anesthesia were randomly divided into 2 groups equally(n= 30) including control group and Narcotrend monitoring group (group N ) .Patients were anesthetized with remifentanil ,propofol and vecuronium ,and intubated . Propofol and remifentanil infusion was adjusted according to clinical parameters(to prevent hypertension ,tachycardia ,etc .) in con‐trol group ,while it was adjusted to keep the Narcotrend index at D0 in group N .Duration of anesthesia and the time needed for re‐covery from anesthesia were recorded and anesthetics′ consumption was calculated .Results Compared with control group ,patients in group N needed significantly less propofol ,opened their eyes earlier ,and were extubated sooner (P < 0 .05) .However ,the two groups were not statistically different in the comparison in duration of anesthesia and remifentanil dosages(P> 0 .05 ,respectively) . Conclusion The results indicate that Narcotrend monitoring is effective to reduce propofol consumption and recovery times during propofol‐remifentanil anesthesia .