摘要
背景与目的:CT定位下肝癌微波消融术是治疗肝癌的微创手术方法,异丙酚-芬太尼全凭静脉麻醉是其常用的麻醉方法,该类手术麻醉深度判断仍以临床征象为主,缺乏客观有效的判断指标。本研究旨在探讨Narcotrend在肝癌微波射消融中异丙酚-芬太尼全凭静脉麻醉深度监测的应用。方法:选择肝癌患者40例,拟于CT定位下行肝癌微波消融术。患者随机分为两组,每组20例,一组为Narcotrend组,另一组为临床组。两组患者均接受异丙酚-芬太尼全凭静脉麻醉,Narcotrend组患者术中根据Narcotrend调节麻醉深度,Narcotrend值维持在D2～E0;临床组患者术中患者根据心率、血压及患者体动调节麻醉深度。分别记录两组患者的血流动力学、清醒时间、定向力恢复时间、异丙酚和芬太尼用量及术后患者的VAS评分及恶心呕吐发生率。结果:两组患者相对应时段的血流动力学变化差异无统计学意义(P>0.05),两组患者麻醉诱导后心率和血压均下降,与其他时段相比差异均有统计学意义(P<0.05);临床组患者异丙酚用量(460±30)mg,Narcotrend组患者异丙酚用量为(380±35)mg(P<0.01);Narcotrend组患者苏醒时间和定向力恢复时间分别为(4.9±2.2)min、(6.6±3.2)min,临床组患者苏醒时间和定向力恢复时间分别为(9.5±2.9)min、(12.2±3.5)min,Narcotrend组患者苏醒时间和定向力恢复时间均缩短(P<0.01);两组患者芬太尼用量、术后VAS评分及恶心呕吐发生率差异均无统计学意义(P>0.05)。结论:Narcotrend在肝癌微波消融术中异丙酚-芬太尼全凭静脉麻醉深度监测有助于减少异丙酚用量,缩短患者恢复清醒时间。
Background and Objective：CT-guided microwave coagulation is a minimally invasive surgery for liver cancer.Total intravenous anesthesia with propofol and fentanyl is commonly used.Anesthesia in-depth monitor in the microwave coagulation for liver cancer is still judged by clinical signs.There were lack of subjective and effective indicators.This study was to explore the application of Narcotrend-assisted anesthesia in-depth monitor in the microwave coagulation for liver cancer during total intravenous anesthesia with propofol and fentanyl.Methods：Forty liver cancer patients who received CT-guided microwave coagulation （PMC） were randomly individed into Narcotrend group and clinical practice group with 20 patients in each group.All patients received total intravenous anesthesia with propofol and fentanyl.The patients in the Narcotrend group adjusted anesthesia in-depth according to Narcotrend index.Narcotrend index was maintained between D2 and E0.Those in the clinical practice group adj...更多usted anesthesia in-depth according to heart rate,mean arterial pressure,and patient movement.Changes of hemodynamics and the durations of emergence and orientation recovery were recorded.The doses of propofol and fentanyl,postoperative visual analogue scores （VAS）,and the incidence of postoperative nausea and vomiting were also recorded.Results：There were no significant changes of heart rate or mean arterial pressure between two groups.Compared with other stages in two groups,both heart rate and mean arterial pressure were decreased during anesthesia induction （P〈0.05）.The doses of propofol were larger in the clinical practice group than in the Narcotrend group [（460±30） mg vs.（380±35） mg,P〈0.01].The durations of emergence and orientation were longer in the clinical practice group than in the Narcotrend group [（9.5±2.9） min vs.（4.9±2.2） min,P〈0.01 （12.2±3.5） min vs.（6.6±3.2） min,P〈0.01].There were no differences in the dose of fentanyl,VAS,and the incidence of postoperative nausea and vomiting between two groups （P 〉0.05）.Conclusions：Narcotrend-assisted anesthesia in-depth monitor in the microwave coagulation for liver cancer can contribute to reducing the dose of propofol and shortening the duration of recovery during total intravenous anesthesia with propofol and fentanyl.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2010年第1期117-120,共4页
Chinese Journal of Cancer
