意识指数监测在无痛肠镜检查术中的应用效果

发布时间：2018-06-22 14:15

本文选题：意识指数监测 + 丙泊酚　；参考：《临床麻醉学杂志》2015年07期

【摘要】：目的观察意识指数(index of consciousness,IoC)监测在无痛肠镜检查术中的临床效果。方法选择自愿行无痛肠镜的男性患者200例,年龄18~65岁,随机均分为观察组(IoC组)和对照组(C组)。两组患者均采用TCI丙泊酚复合瑞芬太尼麻醉,丙泊酚血浆靶浓度从4.0μg/ml起始,瑞芬太尼0.05μg·kg-1·min-1持续泵注。IoC组IoC指数保持在50±3,根据IoC值调整丙泊酚靶浓度;C组术中根据血流动力学及体动反应调整麻醉深度。记录给药前即刻(T1)、睫毛反射消失(T2)、过脾曲(T3)、过肝曲(T4)和苏醒时(T5)的MAP、HR、SpO2及镜检时间、丙泊酚用量、术后苏醒时间、定向力恢复时间及正常行走时间,观察术中不良反应发生情况。结果与C组比较,IoC组丙泊酚用量明显减少,苏醒时间及定向力恢复时间明显缩短(P0.05),体动发生率明显降低(P0.05)。两组镜检时间、正常行走时间和呼吸抑制、头晕、恶心呕吐等不良反应发生率差异无统计学意义。结论 IoC监测用于无痛肠镜检查术可减少麻醉药物用量,缩短恢复时间。
[Abstract]:Objective to observe the clinical effect of (index of consciousness index IOC monitoring in painless enteroscopy. Methods 200 male patients, aged 18 to 65 years, who voluntarily underwent painless enteroscopy, were randomly divided into observation group (IOC group) and control group (C group). Both groups were anesthetized with propofol and remifentanil. The plasma target concentration of propofol began at 4.0 渭 g/ml. The IOC index of remifentanil 0.05 渭 g kg-1 min-1 continuous pump group was maintained at 50 卤3. The anesthesia depth was adjusted according to the target concentration of propofol according to IOC value. The time of MAPHR-SPO _ 2, propofol dosage, recovery time, recovery time and normal walking time were recorded immediately before administration (T _ 1), disappearance of eyelash reflex (T _ 2), hypersplenic curvature (T _ 3), liver curvature (T _ 4) and recovery time (T _ 5). Results compared with group C, the dosage of propofol in IOC group was significantly reduced, the recovery time of recovery time and directional force were significantly shortened (P0.05), and the incidence of body movement was significantly decreased (P0.05). There was no significant difference in the incidence of adverse reactions such as microscopic examination time, normal walking time, respiratory depression, dizziness, nausea and vomiting between the two groups. Conclusion IOC monitoring for painless enteroscopy can reduce the dosage of anesthetic and shorten the recovery time.
【作者单位】：南京中医药大学第二附属医院麻醉科;
【分类号】：R614

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