摘要
目的观察熵指数联合肌松监测在老年全麻诱导期的临床应用效果。方法择期上腹部手术患者60例,性别不限,年龄65~80岁,美国麻醉医师协会(ASA)分级Ⅱ~Ⅲ级。用数字随机法将患者分为Ⅰ、Ⅱ、Ⅲ组,每组20例,分别为熵指数监测联合肌松监测组(Ⅰ组)、熵指数监测组(Ⅱ组)、常规监测组(Ⅲ组)。观察并记录三组在麻醉前(T_0)、诱导后(T_1)、气管插管即刻(T_2)、气管插管后1 min(T_3)、气管插管后5 min(T_4)时的收缩压、舒张压和心率;三组肌松药推注完毕到气管插管的时间。结果与Ⅲ组相比,Ⅰ、Ⅱ组在T_2、T_3时的收缩压与心率相比升高的幅度较小,有统计学意义(P均<0.05)。在T_2、T_3时Ⅱ组的收缩压和心率与Ⅰ组相比升高的幅度较大(P均<0.05),在T_4时Ⅰ、Ⅱ组的收缩压和心率无统计学意义。Ⅲ组在T_2、T_3时的收缩压和心率与T_0、T_1时比较,升高较明显(P均<0.05),而Ⅰ、Ⅱ组则变化较小。不同时点和不同分组的舒张压之间关系不存在差别(P均>0.05)。实验组中肌松药推注完毕到气管插管的时间明显长于对照组(P均<0.05),实验组中Ⅰ组插管时间相比Ⅱ组显著延长。结论熵指数联合肌松监测老年患者全麻诱导期的血流动力学维持比较平稳,气管插管条件和声门暴露程度较好。
Objective To observe the effect of entropy index combined with muscle relaxation monitoring in induction period of general anesthesia in elderly patients. Methods 60 patients undergoing elective upper abdominal surgery,gender,age 65-80,American Society of anesthesiologists（ ASA） grade Ⅱ- Ⅲ . The patients were divided into groups Ⅰ , Ⅱ and Ⅲ by digital random method. There were 20 patients in each group. They were entropy index monitoring group,muscle relaxant monitoring group（ Group Ⅰ ）,entropy index monitoring group（ Group Ⅱ）,and routine monitoring group（ Group Ⅲ ）. Observe and record the three groups before anesthesia（ T0）,after induction（ T1）,immediately after tracheal intubation（ T2）,1 min after intubation（ T3）,5 min after intubation（ T4）,systolic pressure,diastolic pressure and heart rate; three groups of muscle relaxant injection after tracheal intubation time. Results Compared with group Ⅲ ,the systolic pressure of group Ⅰ and Ⅱ in T2 and T3 increased slightly compared with heart rate（ P〈0.05）. At T2 and T3,the systolic pressure and heart rate in group Ⅱ were higher than those in group Ⅰ （ P 〈0. 05）,and there was no significant difference in systolic blood pressure and heart rate between group Ⅰ and Ⅱ at T4. The systolic pressure and heart rate of group Ⅲ at T2 and T3 were significantly higher than those of T0 and T1（ P 〈0. 05）,while those in group Ⅰ and Ⅱ were less changed.There was no difference in diastolic blood pressure at different time points and between groups（ P〉0.05）. In the experimental group,the duration of the injection of muscle relaxant to tracheal intubation was significantly longer than that of the control group（ P〈 0.05）,and the time of intubation in the experimental group was significantly longer than that in the second group. Conclusions Under the monitoring of entropy index combined with muscle relaxation,the hemodynamics of the elderly anesthesia induction period is relatively stable,
作者
万智钢
曹晖
吴丽丽
周兴根
王洁
Wan Zhigang, et al.(Wujiang First People＇s Hospital, Soochow 215200, Chin)
出处
《齐齐哈尔医学院学报》
2017年第24期2860-2862,共3页
Journal of Qiqihar Medical University
关键词
熵指数
肌松监测
老年
全麻诱导期
Entropy index
Muscle relaxation monitoring
the eiders
General anesthesia induction period
