摘要
目的:探究Narcotrend在老年患者快通道全凭静脉麻醉中的指导意义。方法:选择择期行腹腔镜下胃肠道手术的老年患者40例,均采用丙泊酚-瑞芬太尼全凭静脉麻醉,随机分为两组。N组:Narcotrend监测组,凭借Narcotrend监测麻醉深度反馈调节麻醉药物用量;D组:对照组,根据临床经验或体征反馈调节麻醉药物用量,以在术毕15min以内Steward评分≥4分成功拔除气管导管者为快通道麻醉实施。记录两组丙泊酚总用量、拔管时间,并记录两组拔管时不良反应的发生率,术后24h随访术中知晓发生情况。结果:N组快通道麻醉成功率显著高于D组(P<0.05);N组的丙泊酚总用量、苏醒时间和拔管时间显著高于D组(P<0.05);N组拔管后总不良反应发生率显著低于D组(P<0.05);随访两组均无术中知晓发生者。结论:Narcotrend监测能有效指导老年患者快通道全凭静脉麻醉的实施,缩短术毕拔管时间和提高苏醒质量,加速患者的康复。
Objective:To observe the guidance of Narcotrend in fast-tracking total intravenous anesthesia during elderly patients.Methods:Forty elderly patients of gastrointestinal surgery laparoscopic surgery under during total intravenous anesthesia were randomly divided into two group:the study group and the control group.In the study group Narcotrend was monitored the depth of anesthesia to adust the dosage of anesthesia drugs.While in the control depth of anesthesia was determined by clinical experience.It was identified that the fast-tracking total intravenous anesthesia was successful if the patients was extubation and the Steward scores excessed four during fifteen minutes after the surgery was completed.The total dose of propofol,extubation-time,the adverse reaction during extubation and intraoperative awareness were recorded.Results:The successful rate of fast-tracking anesthesia in the study group was higher than the control group(P﹤0.05).The amount of propofol,the waking time and extubation-time of the control group were higher than the study group(P﹤0.05).The rate of adverse reaction during extubation in the study group was significantly less than the control group(P﹤0.05).There was none intraoperative awareness in two group.Conclusions:The Nacrotrend can effectively guide the implementation of fast-tracking total intravenous anesthesia during elderly patients,which can shorten the extubation-time and improve awakening comfort,so that this can accelerated rehabilitation of patients.
作者
郭锐
曾凡颖
钟茂林
许厚仁
邓云菱
王力峰
GUO Rui;ZENG Fan-ying;ZHONG Mao-lin;XU Hou-ren;DENG Yun-lin;WANG Li-feng(Department of Anesthesiology,The Frist Affiliated Hospital of Ganan Medical University,Jiangxi 341000;Ganzhou maternal and child health care center,Ganzhou,Jiangxi 341000)
出处
《赣南医学院学报》
2019年第9期889-892,共4页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
基金
赣州市科技局课题(GZ2016ZSF039)
