Narcotrend脑电监测用于老年患者麻醉的临床研究

摘要

目的 观察Narcotrend脑电监测用于老年患者麻醉的临床效果.方法 选择60例ASAⅠ或Ⅱ级择期行直肠或结肠手术的老年患者,随机均分为两组,采用丙泊酚复合瑞芬太尼靶控输注(TCI)麻醉.研究组在Narcotrend脑电监测指引下,调节丙泊酚靶控浓度维持NT分级在D2～E0之间,对照组依据临床体征调节丙泊酚靶控浓度.记录麻醉诱导前10 min(麻醉前,T1)、麻醉诱导后(T2)、手术开始时(T3)、术中(T4)、术毕时(T5)的MAP、HR和NT分级.记录麻醉药用量及术后苏醒情况.结果 与对照组比较,T2～T4时研究组NT分级处于D2～E0水平的数据比例更多,NT分级减低(P＜0.05),同时丙泊酚用量减少,术后睁眼时间缩短(P＜0.05).结论 将Narcotrend脑电监测用于指导老年患者麻醉,可以使麻醉深度控制更为理想,丙泊酚用量减少,术后睁眼时间缩短.%Objective To observe the effect of Narcotrend-assited propofol/remifentanil anesthesia in the elderly patients. Methods Sixty ASA Ⅰor Ⅱ， aged 60-75 patients undergoing elective low abdominal intestinal surgery were randomized to receive Narcotrend-controlled propofol/remifentanil anesthetic regimen (experimental group) or standard practice (control group). In experimental group, propofol were adjusted to achieve a Narcotrend level D2-E0, which was recommended for moderate to deep anesthetic depth for surgery. In control group, propofol were adjusted by clinical signs. Narcotrend level, hemodynamic parameters, drug consumption and the recovery property were recorded. Results More Narcotrend values were within the target level (D2-E0) and the variance of the Narcotrend data was lower in experimental group compared with control group(P<0. 05). In experimental group, the consumption of propofol was lower and time to eyes-open was shorter. Conclusion Guidance of anesthesia with the Narcotrend-monitor guided anesthesia in the elderly patients is a good method to control the anesthesia depth, with less propofol consumption and shorter time