Narcotrend监测下全凭静脉麻醉不同麻醉深度对直肠癌根治术苏醒质量的影响
|
摘要
目的探究Narcotrend(NT)监测下全凭静脉麻醉(TIVA)不同麻醉深度对直肠癌根治术苏醒质量的影响。方法将160例给予TIVA的直肠癌患者随机分为A、B、C组,分别为53、53、54例。采用NT监测系统调整靶控麻药指数(NI),将其NI控制在不同麻醉深度,A组NI为47～56(D_1级),B组NI为37～46(D_2级),C组NI为27～36(E_0级)。比较三组手术情况、MAP、HR、StO_2、MAAS、SAS、VRS评分及不良事件发生情况。结果 A组和B组的自主呼吸恢复时间、苏醒时间及拔管时间均显著短于C组(P<0.05)。拔管前,C组的MAP、HR、StO_2均显著低于A组和B组(P<0.05);拔管后,B组的MAP、HR、StO_2均显著优于A组和C组(P<0.05)。B组拔管后的MAAS、SAS及VRS评分显著低于A组和C组(P<0.05)。复苏期间,B组的不良事件总发生率显著低于A组和C组(P<0.05)。结论 NT监测下进行直肠癌根治术,可较好的控制NI为37～46(D_2级),可显著降低不良事件发生率,苏醒质量好,值得推广应用。
Objective To investigate the effect of different depth of total intravenous anesthesia(TIVA) monitored by Narcotrend(NT) on the revival quality after radical resection of rectal cancer. Methods One hundred and sixty cases of rectal cancer patients were randomly divided into groups A, B and C, with 53, 53 and 54 cases in each group respectively. NT monitoring system was used to adjust target-controlled anesthetic index(NI) and control NI at different anesthetic depths. NI in the group A was 47-56(D_1), NI in the group B was 37-46(D_2), and NI in the group C was 27-36(E_0). The operation conditions, MAP, HR, StO_2, scores of MAAS, SAS and VRS and adverse events were compared among the three groups.Results The recovery time of spontaneous breathing, recovery time and extubation time in the groups A and B were significantly shorter than those in the group C(P <0.05). Before extubation, the MAP, HR and StO_2 in the group C were significantly lower than those in the groups A and B(P<0.05). After extubation, the MAP, HR and StO_2 in the group B were significantly better than those in the groups A and C(P<0.05). The scores of MAAS, SAS and VRS in the group B after extubation were significantly lower than those in the groups A and C(P<0.05). During resuscitation, the total incidence of adverse events in the group B was significantly lower than those in the groups A and C(P <0.05). Conclusion Radical resection of rectal cancer under NT monitoring can better control the NI is 37-46(D_2), significantly reduce the incidence of adverse events and improve the quality of awakening, which is worthy of popularization and application.
Objective To investigate the effect of different depth of total intravenous anesthesia(TIVA) monitored by Narcotrend(NT) on the revival quality after radical resection of rectal cancer. Methods One hundred and sixty cases of rectal cancer patients were randomly divided into groups A, B and C, with 53, 53 and 54 cases in each group respectively. NT monitoring system was used to adjust target-controlled anesthetic index(NI) and control NI at different anesthetic depths. NI in the group A was 47-56(D_1), NI in the group B was 37-46(D_2), and NI in the group C was 27-36(E_0). The operation conditions, MAP, HR, StO_2, scores of MAAS, SAS and VRS and adverse events were compared among the three groups.Results The recovery time of spontaneous breathing, recovery time and extubation time in the groups A and B were significantly shorter than those in the group C(P <0.05). Before extubation, the MAP, HR and StO_2 in the group C were significantly lower than those in the groups A and B(P<0.05). After extubation, the MAP, HR and StO_2 in the group B were significantly better than those in the groups A and C(P<0.05). The scores of MAAS, SAS and VRS in the group B after extubation were significantly lower than those in the groups A and C(P<0.05). During resuscitation, the total incidence of adverse events in the group B was significantly lower than those in the groups A and C(P <0.05). Conclusion Radical resection of rectal cancer under NT monitoring can better control the NI is 37-46(D_2), significantly reduce the incidence of adverse events and improve the quality of awakening, which is worthy of popularization and application.
引文
[1]向德雨,秦章禄,郭朝阳,等.不同二氧化碳气腹压对腹腔镜结直肠癌手术患者腹腔微转移的影响[J].中国基层医药,2016,23(5):774-777.
[2]MILLER RD.米勒麻醉学[M].邓小明,曾因明译.北京:北京大学医学出版社,2006.
[3]郑树.直肠癌诊治进展[A].中国中西医结合学会大肠肛门病专业委员会.大肠肛门病论文汇编[C]//中国中西医结合学会大肠肛门病专业委员会:中国中西医结合学会,2001:12.
[4]崔雅楠.吸入麻醉与全凭静脉麻醉在脊柱外科手术中的应用价值[J].中国药物经济学,2016,11(7):105-107.
[5]邓佳,蒋璐,许婷,等.Narcotrend麻醉深度监测在全麻中的应用[J]四川医学,2016,37(2):167-170.
[6]田胜兰,周游,冯丹.目标导向液体治疗在择期神经外科手术中对颅内压和脑氧供需平衡的影响[J].华中科技大学学报:医学版2015,44(1):106-109.
[7]刘金虎.老年患者全身麻醉术后苏醒期躁动的logistic回归分析[J].中国实验诊断学,2016,20(12):2030-2033.
[2]MILLER RD.米勒麻醉学[M].邓小明,曾因明译.北京:北京大学医学出版社,2006.
[3]郑树.直肠癌诊治进展[A].中国中西医结合学会大肠肛门病专业委员会.大肠肛门病论文汇编[C]//中国中西医结合学会大肠肛门病专业委员会:中国中西医结合学会,2001:12.
[4]崔雅楠.吸入麻醉与全凭静脉麻醉在脊柱外科手术中的应用价值[J].中国药物经济学,2016,11(7):105-107.
[5]邓佳,蒋璐,许婷,等.Narcotrend麻醉深度监测在全麻中的应用[J]四川医学,2016,37(2):167-170.
[6]田胜兰,周游,冯丹.目标导向液体治疗在择期神经外科手术中对颅内压和脑氧供需平衡的影响[J].华中科技大学学报:医学版2015,44(1):106-109.
[7]刘金虎.老年患者全身麻醉术后苏醒期躁动的logistic回归分析[J].中国实验诊断学,2016,20(12):2030-2033.