Narcotrend盲法监测下丙泊酚靶控输注与恒速输注静脉全麻用于儿童纤支镜肺泡灌洗术的比较

发布时间：2018-01-11 15:06

  本文关键词：Narcotrend盲法监测下丙泊酚靶控输注与恒速输注静脉全麻用于儿童纤支镜肺泡灌洗术的比较　出处：《广东医学》2016年22期 　论文类型：期刊论文

  更多相关文章： 丙泊酚 静脉麻醉 靶控输注 支气管肺泡灌洗术 小儿

【摘要】：目的对比研究Narcotrend盲法监测下丙泊酚靶控输注和恒速输注复合静脉麻醉用于小儿纤维支气管镜(简称纤支镜)肺泡灌洗术的临床效果,探讨适合小儿静脉麻醉的优化方案。方法将40例支气管肺炎择期接受纤支镜肺泡灌洗术的患儿随机分为两组:靶控输注组(TCI组)和恒速输注组(CI组),每组20例,全部患儿入室后即安放Narcotrend脑电监测及检测心电图(ECG)、心率(HR)、平均动脉压(MAP)、呼吸(RR)及食指末梢血氧饱和度(Sp O2)。Narcotrend脑电监测屏幕遮挡,数值由专人监控记录,保持麻醉管理者全程不会观察到Narcotrend指数(Narcotrend index,NI)。观察记录麻醉前、手术开始及术中、术毕的NI、MAP、HR、ECG、Sp O2,手术过程中两组患儿发生90%≤Sp O295%超过30 s而需要退镜至主气管并暂停手术的次数;Sp O290%超过30 s而必须完全退出纤支镜辅助呼吸的次数;并统计麻醉总时间、手术总时间、苏醒时间(从停药开始到苏醒评分达6分)及苏醒期并发症。结果与CI组相比,TCI组术中血压下降较明显,患儿术中缺氧发生率较低(P0.01);TCI组在5 min的苏醒评分与CI组差异有统计学意义(P0.05),1 min和10 min评分差异无统计学意义(P0.05)。NI在CI组表现出较大波动;CI组有4例出现苏醒期烦躁,1例出现术中知晓,TCI组无相关并发症发生(P0.05),麻醉和手术时间两组间差异无统计学意义(P0.05)。结论丙泊酚靶控输注静脉麻醉用于小儿纤支镜肺泡灌洗术,可产生稳定的效应室药物浓度,较传统的恒速输注法可以更好地维持麻醉过程中患者脑电意识深度的稳定性,提示麻醉效果更平稳,麻醉苏醒质量更好,是一种值得推荐的麻醉方式,同时也表明脑电意识深度监测用于指导临床麻醉深度的控制具有积极意义。
[Abstract]:Objective to compare the clinical effects of target-controlled infusion of propofol and intravenous anesthesia with constant velocity infusion under Narcotrend blind monitoring for bronchofiberscope alveolar lavage in children. Methods 40 children with bronchopneumonia undergoing bronchoalveolar lavage were randomly divided into two groups: target controlled infusion group (TCI group) and constant-rate infusion group (TCI group). Group CI). All the 20 cases in each group were placed Narcotrend EEG monitoring, electrocardiogram (ECG), heart rate (HR) and mean arterial pressure (ABP) immediately after entering the room. Respiratory RR) and index finger peripheral blood oxygen saturation (SPO _ 2O _ 2). Narcotrend EEG monitor screen occlusion, the value of monitoring by a special person to record. The Narcotrend index Narcotrend index was not observed throughout the course of anesthesia. The NI was recorded before, during and after operation. During the operation, 90% 鈮，

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