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Narcotrend在硬膜外复合全麻结肠癌根治术中的临床应用 被引量:4

Clinical Application of Narcotrend in Patients Undergoing Radical Operation of Colon Cancerunder Epidural Combined Anesthesia
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摘要 【目的】应用Narcotrend对硬膜外复合全麻下行结肠癌根治术患者术中意识水平的监测,获得量化的数据,指导患者麻醉维持期的用药及预测苏醒。【方法】选择结肠癌患者40例,行结肠癌根治术,随机分为两组,使用Narcotrend(N组)调节丙泊酚输注速度,根据经验(C组)来调节丙泊酚输注速度。两组患者均选择硬膜外复合全麻,N组接Narcotrend监测仪,术中控制麻醉深度在DO以下。记录两组患者性别、年龄、体重、身高、麻醉及手术时间、术中出血,基础值(T1)、插管前1min(T2)、插管后1min(T3)、切皮即时(T4)、拔管即时(T6)、拔管后1min(T6)六个时间点血压(BP)、心率(HR)、IN值(Norcotrend指数)。异丙酚、瑞芬太尼的用量和苏醒时问、拔管时间比较。【结果】插管前1min(T2)两组患者血压和心率均较术前明显降低(P〈0.05)。插管后1min(T3)血压和心率较术前无显著变化,两组插管前后、切皮即时及拔管即时及拔管后1minBP、HR无显著变化。N组异丙酚用量较C组明显减少,N组苏醒时间、拔管时间较C组明显缩断,且所有患者术后随访均无术中知晓及伤害性记忆。【结论】Narcotrend能较准确的反映麻醉深度,对指导硬膜外复合全麻下行结肠癌根治术患者麻醉维持期的用药及预测苏醒、避免术中知晓方面有一定价值。 [Objective]To explore the Narcotrend applied in monitoring the intraoperative consciousness level of patients undergoing radical operation of colon cancer under epidural anesthesia combined anesthesia in order to obtain quantization data for guiding the medication at anesthesia maintenance and predicting recovery time. [Methods]Forty patients with colon cancer undergoing radical operation were randomized into two groups. Narcotrend was used in group N for regulating the infusion speed of propofol. The infusion speed of propofol in group C was regulated by the experience. All patients in two groups received epidural combined anesthesia. Patients in group N were connected to Narcptrend monitor instruments. The anesthesia depth was controlled below DO in the operation. Sex, age, weight, height, anesthesia and operation time and intraoperative bleeding were recorded. Blood pressure(BP), heart rate (HR) and IN at baseline value(T1 ), lmin before intubation(T2 ), lmin alter intubation(T3 ), at immediate skin inci- sion(T4 ), at immediate extubation(T5 ) and lmin after extubation('G ) were also recorded. The dosage of propofol and fentanyl, recovery time and extubation time were compared. [ResultslCompared with before treatment, BP and HR in two groups at T2 reduced significantly( P 〈[0.05), and those at T3 had no obvious change. There was no sig- nificant difference in BP and HR at T2, Ta, T4, T. and 6 between two groups. Compared group C, propoful con- sumption in group N was reduced significantly, and the recovery time and extubation time in group N was shortened significantly. No intraoperative awareness and damage memory during the follow up occurred in all patients. [Conclusion]Narcotrend applied in patients undergoing radical operation of colon cancer can more accurately reflect the the depth of anesthesia, and is of value for guiding the medication at anesthesia maintenance, predicting recovery time and avoiding intraoperative awareness of patients undergoing radical opera
出处 《医学临床研究》 CAS 2013年第2期340-342,共3页 Journal of Clinical Research
关键词 结肠肿瘤 外科学 麻醉 硬膜外 麻醉 全身 colonic neoplasms/SU anesthesia,epidural anesthesia,general
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