Narcotrend麻醉深度监测在宫腔镜手术中的应用

摘要

Objective To investigate the effect of Narcotrend for anesthesia depth monitoring in hysteroscopic surgery. Methods From Oct. 2016 to Jan. 2017, 120 patients undergoing hysteroscopic surgery in Reproductive Medi-cine Center of our hospital were randomly divided into control group (group C, n=60) and observation group (group NT, n=60). All the patients were given propofol for intravenous general anesthesia. In the group NT, the anesthesia depth was adjusted according to the Narcotrend value, which was kept in the range of 20 to 56, while the anesthesia depth in group C was adjusted according to the patient's heart rate (HR), blood pressure and body motion. The mean arterial pressure (MAP) and HR were recorded respectively at entering the operating room (T0), before surgery (T1), after surgery (T2), out of the operating room (T3). The operation time, recovery time, dosage of propofol, incidence of intraoperative body motion, the incidence of assisted breathing and the incidence of nausea and vomiting within 1 hour after surgery were compared between the two groups. Results There was no significant difference in the general condition, MAP and HR between the two groups (P>0.05). The dosage of propofol, recovery time, incidence of intraoperative body motion, the incidence of assisted breathing were (314.9±7.64), (8.70±0.41), 23.3%, 5.0%in group NT, versus (341.7±9.89), (9.93± 0.42), 40.0%, 16.7%in group C (P<0.05). There was no significant difference in the incidence of nausea and vomiting between the two groups (3.3%vs 5.0%, P>0.05). Conclusion Narcotrend has great significance for monitoring anesthe-sia depth during hysteroscopic surgery, which can help reduce the dosage of propofol, decrease the incidence of intraop-erative body motion and assisted breathing, and speed up the recovery.%目的 评价Narcotrend麻醉深度监测在宫腔镜手术中的应用效果.方法 选择2016年10月至2017年1月武汉大学人民医院生殖医学中心择期接受宫腔镜手术的患者120例,采用随机数表法将其分为对照组(C组)和观察组(NT组),每组60例.两组患者均接受丙泊酚全凭静脉麻醉.NT组患者术中根据Narcotrend值维持在20~56调节麻醉深度,而C组患者根据心率、血压和患者体动调节麻醉深度.分别记录两组患者入室(T0)、术前即刻(T1)、术毕(T2)、出室(T3)时的平均动脉压(MAP)、心率(HR),比较两组患者的手术时间、苏醒时间、丙泊酚用量、术中体动发生率、辅助呼吸发生率和术后1 h内恶心呕吐发生率.结果 两组患者的一般情况及各时间点的MAP、HR比较差异均无统计学意义(P>0.05);NT组患者丙泊酚用量比C组[(314.9±7.64)vs(341.7±9.89)]减少,苏醒时间较C组[(8.70±0.41)vs(9.93±0.42)]缩短,术中体动发生率(23.3%vs 40.0%)和辅助呼吸发生率(5.0%vs 16.7%)较C组患者低,差异均有统计学意义(P<0.05);NT组和C组患者恶心呕吐发生率为(3.3%vs 5.0%),差异无统计学意义(P>0.05).结论 Narcotrend麻醉深度监测在宫腔镜手术中的丙泊酚用药有较好的指导意义,其能减少丙泊酚用量,降低术中体动和辅助呼吸发生率,且术后苏醒快.