摘要
目的:研究Narcotrend(NT)麻醉深度监护仪对老年腹部手术患者全麻质量的影响。方法:选取医院收治的150例择期行腹部手术老年患者,按照抽签方式将其随机分为观察组和对照组,每组75例。两组手术均采取全身麻醉,对照组凭借临床经验及患者身体指征对麻醉药用量进行调整,观察组在NT麻醉深度监护仪指导下调整麻醉用量,比较两组围手术期麻醉时间、苏醒时间、定向力恢复时间、重症监护病房停留时间及麻醉药使用情况;比较两组患者麻醉前(T_(0))、麻醉30 min后(T_(1))及手术结束时(T_(2))的心率(HR)、平均动脉压(MAP)和NT麻醉监护仪麻醉深度指数(NTI);比较两组手术后Ricker镇静-躁动(SAS)评分、Ramsay镇静(RSS)评分、简易智能量表(MMSE)评分及疼痛视觉模拟(VAS)评分;比较两组患者术后并发症发生率。结果:观察组术后苏醒时间、定向力恢复时间低于对照组,差异有统计学意义(t=2.806,t=2.476;P<0.05);麻醉药依托咪酯和舒芬太尼的使用量显著低于对照组,差异有统计学意义(t=8.349,t=2.158;P<0.05);两组HR、MAP的组内比较T_(1)>T_(2)>T_(0),NTI的组内比较T_(0)>T_(2)>T_(1),差异有统计学意义(F=205.467,F=36.545,F=111.677,F=156.932,F=57.659,F=869.035;P<0.05);观察组NTI在T_(1)、T_(2)时组间比较显著低于对照组,差异有统计学意义(t=14.265,t=9.347;P<0.05);两组术后SAS评分、RSS评分、VAS评分及PSQI评分差异均无统计学意义,观察组MMSE评分显著高于对照组,差异有统计学意义(t=7.992,P<0.05);观察组术后并发症总发生率为10.67%,显著低于对照组(25.33%),两组比较差异有统计学意义(x^(2)=5.465;P<0.05)。结论:NT麻醉深度监护仪指导下调整麻醉药用量可减少老年患者术后苏醒时间,加快患者定向力恢复,且能减少术后并发症发生,有较高的临床应用价值。
Objective:To study the effect of NT sedative depth monitor on the quality of general anesthesia in abdominal surgery of agedness.Methods:150 patients who admitted to hospital and prepared to undergo abdominal surgery were selected as the study objects.They were randomly divided into observation group and control group according to the way of drawing lots,with 75 cases in each group.General anesthesia was used in both groups.The amount of anesthesia of control group was adjusted according to clinical experience and physical indications of patients.The amount of anesthesia of observation group was adjusted under the guidance of NT sedative depth monitor.The anesthesia time,recovery time,recovery time of orientation force,stay time in intensive care unit(ICU)and the use condition of anesthetics perioperative period between the two groups were compared.The heart rates(HR)pre anesthesia(T_(0)),at 30 th minute post anesthesia(T_(1))and at the end of surgery(T_(2)),the mean arterial pressure Ricker sedation agitation(SAS),Ramsay Sedation Score(RSS),Mani Mental State Examination(MMSE)and Visual Analogue Scale(VAS)between the two groups were compared.And the incidences of postoperative complications between the two groups were further compared.Results:The recovery time,the recovery time of orientation force in observation group were significantly lower than those in control group(t=2.806,t=2.476,P<0.05),respectively.And the usage amounts of etomidate and sufentanil in observation group were significantly lower than those of control group(t=8.349,t=2.158,P<0.05),respectively.In the intra-group comparison of HR and MAP in each groups,T_(1)>T_(2)>T_(0).And in the intra-group comparison of NTI in each groups,T_(0)>T_(2)>T_(1),and the differences of them between the two groups were statistically significant(F=205.467,F=36.545,F=111.677,F=156.932,F=57.659,F=869.035,P<0.05),respectively.The NI at T_(1) and T_(2) in observation group were significantly lower than those in control group(t=14.265,t=9.347,P<0.05),respectively.There
作者
卫晓娜
程晶晶
王向辉
陈永学
WEI Xiao-na;CHENG Jing-jing;WANG Xiang-hui(Department of Anesthesiology,Handan Central Hospital,Handan 056002,China)
出处
《中国医学装备》
2021年第4期110-114,共5页
China Medical Equipment
基金
河北省重点研发计划(182777222)“麻醉对手术麻醉患者生理机能的影响”
河北省医学科学研究课题计划(20191862)“麻醉深度对腹部手术患者术后睡觉质量的影响”。
