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Narcotrend脑电意识深度监测系统在无痛ERCP中的临床观察
【摘要】 目的使用Narcotrend指数(NTI)在无痛内窥镜逆行胰胆管造影(ERCP)监测麻醉深度,评估其临床安全性、有效性,以确立无痛ERCP时恰当的NTI范围并指导临床。方法 90例住院行无痛ERCP患者参加本临床观察,Narcotrend监护仪监护术中镇静深度指数,通过靶控输注(TCI)异丙酚及瑞芬太尼,调整NTI水平并随机分成3组,每组30例,3组患者分别控制NTI值为:A组NTI=40~49,B组NTI=50~59,C组NTI=60~69。记录术中生命体征、呛咳体动、恶心呕吐、术中知晓等不良反应发生情况,记录操作时间、苏醒时间、麻醉药物用量等。结果 3组无痛ERCP患者中,A组及C组不良反应显著高于B组(P<0.05),A组苏醒时间最长,使用麻醉药物最多(P<0.05)。结论在无痛ERCP中使用Narcotrend脑电意识深度监测系统指导麻醉,NTI在50~59之间,具有较高的安全性和有效性。
【Abstract】 Objective To monitor the depth of anesthesia in painless endoscopic retrograde cholangiopancreatography (ERCP) by using Narcotrend Index (NTI),assessing its clinical safety,efficacy,in order to establish the appropriate range of NTI in a painless ERCP and serve as a clinical guidance.Methods 90 cases of hospitalized patients that undertook painless ERCP attended this clinical observation.Narcotrend monitored intraoperative sedation depth index,the NTI level was adjusted by target-controlled infusion (TCI) of propofol and remifentail.All the patients were randomLy divided into three groups,30 patients each.The NTI value of the three groups was:group A of NTI=40 ~ 49,group B of NTI=50 ~ 59,group C of NTI=60 ~ 69,respectively.Recored the vital signs,adverse reaction,including cough,body movement,nausea,vomiting and intraoperative awareness.Also,the operating time,recovery time,the amount of narcotic drugs were recorded.Results Within all the three groups,adverse reactions in group A and group C was significantly higher than group B (P<0.05).The patients in group A took the longest time to wake up (P<0.05) and consumed the largest amount of narcotic drugs (P<0.05).Conclusion Using Narcotrend electroencephalogram monitoring system to guide the process of anesthesia during painless ERCP,with NTI between 50 and 59,have more safety and efficacy.
【Key words】 Narcotrend; Depth of anesthesia; Target controlled infusion; Painless ERCP; Intraoperative awareness;
- 【文献出处】 当代医学 ,Contemporary Medicine , 编辑部邮箱 ,2012年34期
- 【分类号】R614
- 【被引频次】6
- 【下载频次】97