Narcotrend监测应用于不同年龄段全麻患者苏醒情况比较

发布时间：2018-05-12 19:20

本文选题：Narcotrend + 麻醉深度　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：本研究目的是探讨Narcotrend监测应用于不同年龄段全麻患者苏醒情况比较。方法：选取吉林大学白求恩第一医院2013年12月~2014年2月择期行全身麻醉下腹腔镜胃癌根治术患者100名，ASAI或II级，A组为年龄65~80岁患者50名，B组为年龄40~64岁患者50名。把A组患者按照随机表格法分成2组：A1组（Narcotrend监测组，n=25），A2组（对照组，n=25），把B组患者按照随机表格法分成2组：B1组（Narcotrend监测组，n=25），B2组（对照组，n=25）。在A1和B1组，手术过程中将Narcotrend值控制在D2（46~37）期，A2和B2组患者进行Narcotrend监测，但施麻醉者无法看到Narcotrend数值，根据临床经验进行术中管理。患者入室后常规监测BP、HR、SPO2，麻醉诱导设定丙泊酚初始效应室浓度3.5μg ml，靶控输注丙泊酚2-4μg ml和瑞芬太尼6-8g kg h进行麻醉维持，，缝合皮肤时停止丙泊酚的输注。记录不同时间点Narcotrend值、平均动脉压(MAP)、心率(HR)、丙泊酚效应室浓度，不同时间点分别为基础值（T1），气管插管前1min（T2），气管插管后即刻（T3），打入气腹前1min（T4），打入气腹后即刻（T5），手术结束时（T6）。分别比较A1、A2组和B1、B2组患者苏醒时间。结果：A1组患者苏醒时间明显小于A2组，B1组与B2组相比患者苏醒时间无临床意义。结论：应用Narcotrend监测能减少丙泊酚的用量，缩短老年患者苏醒时间，对缩短年轻患者苏醒时间无临床意义。
[Abstract]:Objective: to explore the comparison of Narcotrend monitoring in patients with general anesthesia in different age groups. Methods: from December 2013 to February 2014, 100 patients with gastric cancer undergoing laparoscopic radical gastrectomy under general anesthesia in Bai Qiuen first Hospital of Jilin University were selected as group A and group A: 50 patients aged 65 to 80 years old, group B: 50 patients aged 40 to 64 years. The patients in group A were randomly divided into two groups according to the random table method: 1: 1 group Narcotrend monitoring group (control group) and group B (control group) were divided into two groups according to the random table method: group B, Narcotrend monitoring group (group B), group B (control group), group B (n = 25). In group A1 and group B1, the Narcotrend value was controlled at D _ 2 ~ (46 ~ (37) during operation. The patients in group A _ 2 and group B _ 2 were monitored for Narcotrend, but the anesthesiologist could not see the value of Narcotrend and managed it according to the clinical experience. BPHR-SPO _ 2 was routinely monitored after anesthesia induction, the initial concentration of propofol was set at 3.5 渭 g / ml, the target controlled infusion of propofol 2-4 渭 g / ml and remifentanil 6-8 g / kg / h were used for anesthesia maintenance, and the infusion of propofol was stopped during skin suture. The Narcotrend values, mean arterial pressure, heart rate, propofol effect chamber concentration were recorded at different time points, respectively. At different time points, the baseline values were T _ 1, T _ 2, T _ 3, T _ 3, T _ 5 and T _ 5 immediately before pneumoperitoneum and pneumoperitoneum, respectively, at the end of operation. The recovery time of A _ 1 A _ 2 group and B _ 1 B _ 2 group were compared. Results there was no clinical significance between group A 1 and group B 2 when compared with group B 2. The recovery time of group A 1 was significantly shorter than that of group B 1. Conclusion: Narcotrend monitoring can reduce the dosage of propofol, shorten the recovery time of elderly patients, and has no clinical significance in shortening the recovery time of young patients.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614.2

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