摘要
目的探讨鼻内镜全麻手术患者术毕Narcotrend麻醉深度监测仪指导下泵入丙泊酚的应用及其对患者苏醒质量的影响。方法选取2016年2月至2017年4月在全麻下行鼻内镜手术患者100例进行前瞻性研究,采取计算机随机抽取手术编号法分为研究组(术毕在Narcotrend指导下泵入丙泊酚维持麻醉深度在C2~C0,50例)和对照组(术毕不予以处理,50例),比较两组患者在入室时(T0)、术毕(T1)、拔管时(T2)、拔管5 min(T3)、拔管10 min(T4)的平均动脉压(MAP)、心率(HR)、麻醉趋势指数(Narcotrend index,NI),比较两组患者自主呼吸恢复时间、麻醉恢复室驻留时间、拔管后10 min疼痛及呛咳、拔管记忆、喉咙不适、烦躁等苏醒期不良反应发生率。结果研究组患者在T2、T3时点MAP、HR水平低于对照组(P均<0.05),显示其MAP、HR水平更平稳。两组患者T1至T4时点NI水平均较T0下降(P均<0.05);且在T1、T2、T3时点,研究组患者NI值均较对照组降低(P均<0.05)。两组患者自主呼吸恢复时间、麻醉恢复室驻留时间、拔管后10 min疼痛评分比较差异均无统计学意义(P均>0.05)。研究组患者麻醉苏醒期呛咳、拔管记忆、喉咙不适及烦躁发生率均低于对照组(P<0.05,P<0.01)。结论鼻内镜全麻手术患者术毕在Narcotrend指导下泵入丙泊酚,可维持患者麻醉苏醒期血流动力学的稳定,降低苏醒期不良反应发生率,并不影响患者苏醒时间,可显著提高患者麻醉苏醒质量。
Objective To explore the application of pumped propofol by the guidance of Narcotrend anesthesia depth monitoring and the effect on awakening quality in patients after endoscopic surgery under general anesthesia. Methods A prospective study was performed on 100 patients receiving endoscopic sinus surgery under general anesthesia from February 2016 to April 2017. According to random number method by computer, all patients were divided into study group （propotbl infusion guided by Narcotrend to maintain anesthesia depth in C2 - C0 after operation, n = 50） and control group （ no processing after operation, n = 50 ）. The mean arterial pressure （ MAP）, heart rate （ HR）, Narcotrehd index （NI） were compared at baseline （ T0 ）, end of operation （ T1 ）, at extubation （ T2 ） , 5 min after extubation （ T3 ） , 10 min after extubation （T4 ） between two groups. The spontaneous breathing recovery time, anesthesia recovery room residence time, pain score and the incidence of adverse reaction including pain, bucking, extubation memory, throat discomfort, irritability during recovery period of 10 min after extubation were also observed and compared between two groups. Results The levels of MAP and HR in study group were lower than those in control group at T2 and T3 （ all P 〈 0. 05 ）, showing that the levels of MAP and HR in study group were more stable. NI value significantly decreased from T1 to T4 in two groups compared with T0 （all P 〈 0. 05 ）. At T1 , T2 and T3 time points, NI value in study group was statistically lower than those in control group （ all P 〈 0. 05 ）. There were no significant differences in spontaneous breathing recovery time, anesthesia recovery room residence time, pain score of 10 minutes after extubation between two groups （all P 〉 0. 05 ）. The incidence of bucking, extubation memory, throat discomfort, irritability during recovery period was significantly lower in study group than those in control group （ P 〈 0.05, P 〈 0. 01 ）. Conclusion For patients after endoscopic surgery under general anesthesia,pumping propofol by the guidance of Narcotrend can maintain hemodynamic stability, reduce the incidence of adverse reactions does not affecting the recovery time of patients during anesthesia recovery period, so it significantly improves the palinesthesia quality of patient.
出处
《中国临床研究》
CAS
2018年第1期108-111,共4页
Chinese Journal of Clinical Research
基金
惠州市科技计划项目(20160802)
