Narcotrend检测仪、脑电双频指数用于颅脑手术患者麻醉深度监测的效果

发布时间：2018-07-01 11:55

本文选题：神经外科手术 + 麻醉　；参考：《中国全科医学》2016年S1期

【摘要】：目的探讨Narcotrend(NT)检测仪、脑电双频指数(BIS)用于颅脑手术患者麻慣深度监测的效果。方法选取2016年1—9月舟山医院收治的45例颅脑手术患者为研究对象,按随机数字表法分为对照组、BIS组、NT组,各15例。监测3组患者麻慣前、诱导麻慣T、插管T、切头皮、锯颅骨、缝皮6个时间点的呼吸频率(RR)、心率(HR)、平均动脉压(MAP)、血氧饱和度(SPO_2),同时记录3组药物用量、苏醒时间、拔管时间、术中知晓率。结果麻醉方法与时间在RR上无交互作用(P0.05),麻醉时间在RR上主效应不显著(P0.05),麻醉方法在RR上主效应不显著(P0.05)。麻慣方法与时间在HR上有交互作用(P0.05),麻醉时间在HR上主效应显著(P0.05),麻醉方法在HR上主效应显著(P0.05)。麻慣方法与时间在MAP上有交互作用(P0.05),麻醉时间在MAP上主效应显著(P0.05),麻慣方法在MAP上主效应显著(P0.05)。麻慣方法与时间在SPO2上无交互作用(P0.05),麻醉时间在SPO_2上主效应不显著(P0.05),麻慣方法在SPO_2上主效应不显著(P0.05)。对照组插管T、切头皮、锯颅骨、缝皮时MAP、HR高于BIS组、NT组,差异有统计学意义(P0.05)。3组患者6个时间点的RR、SPO_2比较,差异无统计学意义(P0.05)。BIS组、NT组患者丙泊酚、瑞芬太尼和维库溴铵用量少于对照组,差异有统计学意义(P0.05)。NT组与BIS组苏醒时间、术中知晓率、拔管时间比较,差异无统计学意义(P0.05);对照组苏醒时间、拔管时间长于BIS组、NT组,术中知晓率高于BIS组、NT组,差异有统计学意义(P0.05)。结论颅脑术中以BIS值为反馈调控麻醉用药,或采用NT麻慣深浅检测装置给予麻醉指导都能n少丙泊酚等药物用量,有助于患者术后快速苏醒,以准确判断患者病情的变化。
[Abstract]:Objective to investigate the effect of Narcotrend (NT) detector and bispectral index (BIS) in monitoring the depth of anesthesia in patients undergoing craniocerebral surgery. Methods 45 patients with craniocerebral operation were selected from Zhoushan Hospital from January to September 2016. According to the method of random digital table, they were divided into control group (BIS group) and NT group (n = 15 each). The respiratory rate (RR), heart rate (HR), mean arterial pressure (map), blood oxygen saturation (SPO2) were monitored at 6 time points of induction anesthesia T, intubation T, scalp excision, sawbone sawing and suture skin before anesthesia in three groups. The dosage of drugs, recovery time and extubation time were recorded. Intraoperative awareness rate. Results there was no interaction between anesthesia method and time in RR (P0.05), but the main effect of anesthesia time on RR was not significant (P0.05), and the main effect of anesthetic method on RR was not significant (P0.05). There was significant interaction between anesthesia method and time on HR (P0.05), significant effect of anesthesia time on HR (P0.05), and significant effect of anesthesia on HR (P0.05). The main effect of anesthesia time on map was significant (P0.05), and the main effect of anaesthesia method on map was significant (P0.05). There was no interaction between hemp method and time on SPO 2 (P0.05), the main effect of anesthesia time on SPO 2 was not significant (P0.05), and the main effect was not significant on SPO 2 (P0.05). There was no significant difference in MAPHR between BIS group and NT group at the time of intubation T, scalp incision, sawbone sawing and suture skin in control group (P0.05). There was no significant difference in propofol between NT group and BIS group (P0.05), and there was no significant difference in RRN SPO-2 between BIS group and NT group at 6 time points (P0.05). The dosage of remifentanil and vecuronium was significantly lower than that of control group (P0.05). There was no significant difference between NT group and BIS group in waking time, intraoperative awareness rate and extubation time (P0.05); in control group, the recovery time was longer than that in BIS group, and the extubation time was longer than that in BIS group. Intraoperative awareness rate was higher than BIS group NT group, the difference was statistically significant (P0.05). Conclusion during craniocerebral operation, using BIS value as feedback control anesthetic, or using NT anaesthesia test device to give anesthetic instruction can help patients to wake up quickly after operation and judge the change of patient's condition accurately.
【作者单位】：舟山医院麻醉科;
【分类号】：R614

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