摘要
目的比较ConView麻醉深度监测和Narcotrend麻醉深度监测在依托咪酯靶控输注(target controlled infusion,TCI)麻醉中的一致性。方法选取拟行择期中耳手术的患者120例,年龄18~65岁,ASA分级Ⅰ、Ⅱ级,每例患者均同时进行ConView麻醉深度监测(Ai指数)和Narcotrend麻醉深度监测(Nt指数)。采用依托咪酯复合瑞芬太尼静脉TCI麻醉,记录诱导前(T_(1))、诱导后1 min(T_(2))、诱导后3 min(T_(3))、插管后3 min(T_(4))、插管后5 min(T_(5))、手术开始时(T_(6))、手术30 min(T_(7))、手术1 h(T_(8))、手术1.5 h(T_(9))、手术结束时(T_(10))、拔管时(T11)及拔管后5 min(T12)的Nt指数和Ai指数,采用Bland‑Altman一致性分析两种指数的变化趋势。结果Bland‑Altman一致性分析显示,整体Nt指数和Ai指数差值均数为1.20,一致性范围外占比4.58%(66/1440)。仅T2时Nt指数和Ai指数差值均数较大(−9.34),一致性范围外占比为5.00%(6/120)。结论ConView麻醉深度监测仪和Narcotrend麻醉深度监测仪均能客观反映患者接受依托咪酯TCI过程中的实时麻醉深度。
Objective To compare the consistency of ConView anesthesia depth monitoring and Narcotrend anesthesia depth monitoring in target controlled infusion(TCI)of etomidate.Methods A total of 120 patients,aged 18 to 65 years,American Society of Anesthesiologists(ASA)gradeⅠorⅡ,who were scheduled for middle ear surgery were included.Each patient was subjected to both ConView anesthesia depth monitoring(Ai index)and Narcotrend anesthesia depth monitoring(Nt index).Etomidate was used in combination with remifentanil for TCI anesthesia.The Nt index and Ai index were recorded before induction(T_(1)),1 min after induction(T_(2)),3 min after induction(T_(3)),3 min after intubation(T_(4)),5 min after intubation(T_(5)),at the beginning of operation(T_(6)),half an hour after operation(T_(7)),1 h after operation(T_(8)),1.5 h after operation(T_(9)),at the end of operation(T_(10)),during extubation(T_(11))and 5 min after extubation(T_(12)).Bland‑Altman consistency analysis was performed to analyze the changes in the two indexes.Results According to Bland‑Altman consistency analysis,the average difference between the overall Nt index and Ai index was 1.20,and the proportion outside the consistency range was 4.58%(66/1440).The average difference between Nt index and Ai index was larger at T2(−9.34),and the proportion outside the consistency range was 5.00%(6/120).Conclusion Both domestic ConView anesthesia depth monitoring and Narcotrend monitoring can objectively reflect the real‑time depth of anesthesia in patients undergoing TCI with etomidate.
作者
杨玉峰
李姣阳
宫春利
曾毅
Yang Yufeng;Li Jiaoyang;Gong Chunli;Zeng Yi(Department of Anesthesiology and Perioperative Medicine,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)
出处
《国际麻醉学与复苏杂志》
CAS
2023年第5期473-477,共5页
International Journal of Anesthesiology and Resuscitation
基金
陕西省自然科学基础研究计划重点项目(2021JZ‑33)。
关键词
麻醉深度
监测
依托咪酯
靶控输注
麻醉深度监测仪
Depth of Anesthesia
Monitoring
Etomidate
Target controlled infusion
Anesthesia depth monitor
