Narcotrend监测在小儿患者全身麻醉中的价值分析
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摘要
目的探讨Narcotrend监测在小儿患者全身麻醉中的价值。方法选取我院2016年3月~2017年3月收治的全身麻醉手术患儿92例,所有患儿采用异丙酚-七氟烷静吸复合全身麻醉。使用随机数字表法将入选患儿分为观察组、对照组,每组46例。观察组术中异丙酚、七氟烷浓度依据Narcotrend进行调控,对照组异丙酚、七氟烷浓度依据患儿的血压、心率等生命体征和麻醉医生的经验进行调控。比较两组患儿的苏醒时间,拔管时间,七氟烷、异丙酚用量,观察患儿呛咳、恶心呕吐、术后躁动的不良反应发生率。结果观察组患儿的苏醒时间、拔管时间显著短于对照组(P<0.05),观察组患儿的七氟烷、异丙酚使用量显著少于对照组(P<0.05)。观察组的不良反应总发生率为8.70%,显著低于对照组的28.26%(P<0.05)。结论采用Narcotrend麻醉深度监测的全身麻醉小儿患者,麻醉药物用量少,苏醒时间、拔管时间短,不良反应少,是一种简便、高效、实用的麻醉深度监测方法,值得临床推广。
Objective To investigate the value of Narcotrend monitoring in general anesthesia of pediatric patients.Methods92 children undergoing general anesthesia operation treated in our hospital were selected from March 2016 to March2017.All children were treated with Propofol-Seven Halothane inhalation combined with general anesthesia.Using random number method method,all children were divided into the observation group and control group,and each group had46 cases.The concentration of Propofol and Seven Halothane in the observation group were adjusted according to Narcotrend while Propofol and Seven Halothane concentration in the control group were regulated according to the blood pressure,heart rate,and other vital signs and the experience of the anesthesiologist.The recovery time,extubation time,dosage of Propofol and Seven Halothane were compared in pediatric patients between the two groups,and the incidence of adverse reactions such as cough,nausea and vomiting and postoperative agitation in pediatric children were observed.Results The recovery time and extubation time in the observation group were significantly shorter than those in the control group(P <0.05).The dosage of Propofol and Seven Halothane in the observation group was significantly fewer than those of the control group(P<0.05).The total incidence of adverse reactions in the observation group was 8.70%,which was significantly lower than that in the control group(28.26%)(P<0.05).Conclusion Narcotrend anesthesia depth monitoring of anesthesia in pediatric patients has fewer narcotic drugs consumption,recovery time and extubation time are short with fewer adverse reactions,and it is a simple,efficient and practical depth of anesthesia detection method.It is worthy of clinical promotion.
Objective To investigate the value of Narcotrend monitoring in general anesthesia of pediatric patients.Methods92 children undergoing general anesthesia operation treated in our hospital were selected from March 2016 to March2017.All children were treated with Propofol-Seven Halothane inhalation combined with general anesthesia.Using random number method method,all children were divided into the observation group and control group,and each group had46 cases.The concentration of Propofol and Seven Halothane in the observation group were adjusted according to Narcotrend while Propofol and Seven Halothane concentration in the control group were regulated according to the blood pressure,heart rate,and other vital signs and the experience of the anesthesiologist.The recovery time,extubation time,dosage of Propofol and Seven Halothane were compared in pediatric patients between the two groups,and the incidence of adverse reactions such as cough,nausea and vomiting and postoperative agitation in pediatric children were observed.Results The recovery time and extubation time in the observation group were significantly shorter than those in the control group(P <0.05).The dosage of Propofol and Seven Halothane in the observation group was significantly fewer than those of the control group(P<0.05).The total incidence of adverse reactions in the observation group was 8.70%,which was significantly lower than that in the control group(28.26%)(P<0.05).Conclusion Narcotrend anesthesia depth monitoring of anesthesia in pediatric patients has fewer narcotic drugs consumption,recovery time and extubation time are short with fewer adverse reactions,and it is a simple,efficient and practical depth of anesthesia detection method.It is worthy of clinical promotion.
引文
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[10]孟馨,刘宽智,李元涛.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[J].广东医学,2016,37(22):3437-3439.
[11]Solt K,Chemali JJ,Olutola O,et al.Aging delays emergence from general anaesthesia in rats[A]//International Symposium on Memory and Awareness in Anesthesia[C].2015:134-135.
[12]张晓琴,董荣昌,詹锐,等.Narcotrend在小儿手术全身麻醉中的临床应用[J].国际麻醉学与复苏杂志,2015,36(2):130-133.
[13]邵欣欣,李坤河,陈祯,等.Narcotrend脑电监测对活体肾移植患者围术期麻醉管理的影响[J].实用医学杂志,2016,32(17):2871-2874.
[14]武健,唐建成.Narcotrend在结肠癌根治术患者麻醉维持期中的应用[J].热带医学杂志,2016,16(4):477-479.
[15]陶文辉,张庆.麻醉深度监测仪Narcotrend在老年患者中的临床应用进展[J].安徽医学,2016,37(11):127-129.
[2]王薇,石双平,胡柳生,等.小儿先天性心脏病快通道麻醉中Narcotrend脑电监测的应用价值[J].现代中西医结合杂志,2015,24(20):2250-2252.
[3]Yang GH,Wang LX,Lu ZT.Impact of patients′s positions on the narcotrend index during intravenous anaesthesia[J].Med Inno China,2015,13(5):332-336.
[4]Dennhardt N,Boethig D,Beck C,et al.Optimization of initial propofol bolus dose for EEG Narcotrend Index-guided transition from sevoflurane induction to intravenous anesthesia in children[J].Paediatric Anaesthesia,2017,27(4):425-432.
[5]郭静,杨改生.Narcotrend指导全身麻醉对患者麻醉苏醒时间影响的Meta分析[J].中国医药导报,2017,14(1):61-67.
[6]代辉,金立民,周春燕,等.Narcotrend监测对甲状腺癌双侧颈淋巴结清扫术苏醒期质量的影响[J].中国实验诊断学,2016,20(10):1720-1722.
[7]吴江东.麻醉深度监测及其在腹腔镜手术麻醉中的应用[D].南宁:广西医科大学,2013.
[8]张晗,何开华,王彬,等.Narcotrend监测丙泊酚-瑞芬太尼复合麻醉在乳腺癌根治手术中的应用[J].检验医学与临床,2016,13(18):2556-2557.
[9]Guo Z,Pang L,Jia X,et al.Intraoperative target-controlled infusion anesthesia application using remifentanil hydrochloride with etomidate in patients with severe burn as monitored using Narcotrend[J].Burns,2015,41(1):100-105.
[10]孟馨,刘宽智,李元涛.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[J].广东医学,2016,37(22):3437-3439.
[11]Solt K,Chemali JJ,Olutola O,et al.Aging delays emergence from general anaesthesia in rats[A]//International Symposium on Memory and Awareness in Anesthesia[C].2015:134-135.
[12]张晓琴,董荣昌,詹锐,等.Narcotrend在小儿手术全身麻醉中的临床应用[J].国际麻醉学与复苏杂志,2015,36(2):130-133.
[13]邵欣欣,李坤河,陈祯,等.Narcotrend脑电监测对活体肾移植患者围术期麻醉管理的影响[J].实用医学杂志,2016,32(17):2871-2874.
[14]武健,唐建成.Narcotrend在结肠癌根治术患者麻醉维持期中的应用[J].热带医学杂志,2016,16(4):477-479.
[15]陶文辉,张庆.麻醉深度监测仪Narcotrend在老年患者中的临床应用进展[J].安徽医学,2016,37(11):127-129.