摘要
目的 观察以Narcotrend脑电监测下调整异丙酚靶控输注浓度的方法用于老年人经肛小肠镜检查的效果。 方法 选择40例美国麻醉医师协会（ASA）分级Ⅰ或Ⅱ级在全麻下行经肛小肠镜检查的老年患者，采用随机数字表法随机分为试验组和对照组，每组20例。以异丙酚靶控输注进行麻醉，试验组在Narcotrend脑电监测下调整靶浓度，维持麻醉深度于C2水平，对照组依据改良镇静/警醒评分（modified observer assessment of alertness/sedation scale， MOAA/S）评分调整靶浓度，以维持MOAA/S于2分水平。观察两组血流动力学变化情况、异丙酚用量、苏醒时间、副作用、患者及胃肠镜医师满意度。 结果 两组患者平均动脉压、心率、呼吸频率的变化类似，与对照组比较，试验组异丙酚用量减少［试验组（0.068±0.004） mg·kg-1·min-1，对照组（0.088±0.005） mg·kg-1·min-1，P〈0.05］，苏醒时间缩短［试验组（13±4） min，对照组（18±5） min，P〈0.05］，胃肠镜医师满意度增高［试验组（3.0±0.0），对照组（2.8±0.4），P〈0.05］，两组副作用发生率差异无统计学意义。 结论 在老年人经肛小肠镜检查的麻醉中，以Narcotrend脑电监测指引调整异丙酚靶控输注浓度的麻醉方法可以减少异丙酚用量，缩短苏醒时间，提高胃肠镜医师满意度。
objective To observe the effect of Narcotrend-guided target-controlled infusion of propofol in the double balloon enteroscopy in the elderly. Methods Forty ASA Ⅰ-Ⅱ, aged 65-75 patients undergoing double balloon enteroscopy（per anal） were randomized into two groups： target-controlled infusion of propofol guided by narcotrend level（NT group） or modified observer＇s assessment of alertness/sedation score（MOAA/S）（control group）. In NT group, the target concentration of propofol was adjusted to achieve C2 level. In control group, the target concentration was adjusted achieve MOAA/S score of 2. Hemodynamic parameters, drug consumption, recovery time, adverse reactions, patient＇s and endoscopist＇s evaluation of satisfaction were recorded. Results Hemodynamic parameters are similar in both groups. In NT group, the consumption of propofol was less[（0.068±0.004） mg·kg-1·min-1 vs（0.088±0.005） mg·kg-1·min-1,P〈0.05], recovery time was shorter[（13±4） min vs（18±5） min, P〈0.05] and the endoscopist＇s satisfaction was higher[（3.0±0.0） vs（2.8±0.4）, P〈0.05]. There is no significant difference in adverse reactions in both groups. Conclusions Narcotrend-guided anesthesia of propofol leads to less consumption of anesthetics, shorter recovery time and higher endoscopist satisfaction during double balloon enteroscopy in the elderly.
出处
《国际麻醉学与复苏杂志》
CAS
2014年第4期305-308,共4页
International Journal of Anesthesiology and Resuscitation
