Narcotrend对小儿先心病外科手术调控麻醉深度的作用.docVIP

Narcotrend对小儿先心病外科手术调控麻醉深度的作用 华玉芳 黄生辉 张荣智 张双银 徐旭 （730030，兰州大学第二医院麻醉科） 摘要 目的： 探讨 Narcotrend 脑电监测仪在小儿先天性心脏病手术快通道麻醉中的应用 方法：40 例期行房、室间隔缺损修补术患儿，随机分为两组，临床组（C）和Narcotrend（N），组每20例，采用异丙酚复合舒芬太尼静脉全身麻醉。记录两组患儿麻醉诱导前（T0）、气管插管后（T1）、转流前（T2）、转流后（T3）、转流停机前（T4）、转流停机后（T5）、手术结束（T6）7个时间点的HR 和MAP，且均记录两组患儿的CPB 时间，手术时间、听从指令时间以及拔管时间。N 组同时记录 NI，使其维持在D2～E0。结果：N组血流动力学参数波动较小；N组镇静药量、镇痛药量及肌松药使用量比C组明显减少（P＜0．05）;听从指令及拔管时间：C组显著长于N组（P＜0．05）。结论：Narcotrend 脑电监测仪在小儿先天性心脏病快通道麻醉中有助于减少麻醉药的用量，缩短患儿苏醒及在 ICU 停留时间。 关键词：Narcotrend 脑电监测；先天性心脏病；小儿麻醉 The role of Narcotrend monitor on controlling anesthesia depth in surgeries for infants congenital heart disease Hua Yu Fang Huang Sheng Hui, Zhang Rong Zhi et al. [Abstract] Objective To investigate the feasibility and effectiveness of Narcotrend electroencephalogram(EEG)/consciousness depth monitor (NT index) for adjusting anesthesia depth in congenital heart disease (CHD) infants receiving surgeries. Methods A total of 40 CHD infantsd (ASAⅡ-Ⅲ) to be subjected to surgery were randomly selecte and assigned into two groups randomly. In the N group ( n=20), the depth of anesthesia was monitored with NT index; in the C group ( n=20), the anesthesia depth was controlled according to the anesthetists experience without NT index. The ECG, HR, SpO2, the mean arterial pressure of left radioartery, the central venous pressure (CVP) of right cervical vein and NT index were monitored routinely. The NT index, total dose of anesthesia drugs, recovery time, extubation time and possible badness reaction were determined. Results, The dosage of sedative and analgesic drugs and muscle relaxant medicinal volume of the N group decreased significantly than the C group(P 0.05), the recovery time was 3 to 4 hours ahead and the extubation time was 7 to 8 hours in advance (P 0.05). Conclusion The Narcotrend anesthesia depth monitor is safe and beneficial for the control of anesthesia depth in CHD infants receiving surgeries in which anesthesia depth can be quantized, the index and t