Narcotrend在腹腔镜辅助下胃肠癌根治术术中持续循环腹腔热灌注化疗麻醉管理体会.docVIP

Narcotrend在腹腔镜辅助下胃肠癌根治术术中持续循环腹腔热灌注化疗麻醉管理体会 　　【摘要】 目的：探讨Narcotrend在腹腔镜辅助下胃肠癌根治术术中持续循环腹腔热灌注化疗的麻醉管理。方法：筛选2013年3月-2014年11月本院收治的行胃肠癌根治术并术中持续循环腹腔热灌注化疗患者40例作为研究对象。采用随机数表法将其分为观察组与对照组，每组20例，对照组根据麻醉医生临床经验判断实施麻醉，观察组患者采用Narcotrend麻醉深度监测仪指导实施麻醉，比较两组患者各时期患者血流动力学指标及麻醉效果。结果：观察组患者手术时间、麻醉时间与对照组比较差异无统计学意义，但麻醉药物剂量、苏醒时间等明显优于对照组，比较差异具有统计学意义（P0.05）。对照组T2、T3、T4、T5较T0时刻SBP、DBP及HR升高（P0.05）。两组患者T0及T1期SBP、DBP、HR比较差异无统计学意义，但对照组T2、T3、T4、T5时刻SBP、DBP、HR指标高于观察组，比较差异具有统计学意义（P0.05）。结论：对胃肠癌根治术术中持续循环腹腔热灌注化疗患者采用Narcotren麻醉深度监测仪指导实施麻醉，可以更好的维持患者血流动力学稳定，使用较少的麻醉药物达到更好的麻醉效果，有利于患者的苏醒，具有临床应用及推广价值。 　　【关键词】 腹腔镜； 胃肠癌根治术； 术中腹腔热灌注化疗； Narcotrend 　　【Abstract】 Objective： To investigate the anesthesia management of continuous cyclic peritoneal perfusion chemotherapy in gastric cancer radical resection of Narcotrend assisted laparoscopic. Method： 40 continuous cyclic peritoneal perfusion chemotherapy with gastric cancer radical resection patients from 2013 March to 2014 November in our hospital were selected as the research objects. They were randomly divided into observation group and control group， with 20 cases in each group， the control group achieved anesthesia according to the experience of anesthesia doctor’s clinical experience， the observation group was treated by Narcotrend anesthesia depth monitoring to guide the implementation， compared two groups’ each stage hemodynamic indexes and anesthesia effect. Result： The observation group’s operation time， anesthesia time had no significant differences compared with the control group， and its dosage of drugs， wake time was significantly better than the that of the control group （P0.05）， with statistical significance. The control group’s SBP， DBP and HR in T2， T3， T4， T5 had increased compared with T0 time （P0.05）， there was no significant difference between the two groups’ SBP， DBP， HR in T0 and T1 stage， but the control group’s SBP， DBP， HR in T2， T3， T4， T5 were higher than the observation group （P0.05）， with statistical significance. Conclusion： Using Narcotr