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[1]余志阳,郑大东,刘清珍,等.Narcotrend在硬膜外复合全身麻醉患者苏醒期意识恢复预测的评价[J].医学研究与战创伤救治(原医学研究生学报),2014,16(06):575-577.[doi:10.3969/j.issn.1672-271X.2014.06.005]
　YU Zhi-yang,ZHENG Da-dong,LIU Qing-zhen,et al.The predictive effect of Narcotrend monitor on consciousness recovery during emergence of general anesthesia combined with epidural block[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2014,16(06):575-577.[doi:10.3969/j.issn.1672-271X.2014.06.005]
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Narcotrend在硬膜外复合全身麻醉患者苏醒期意识恢复预测的评价()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第16卷
期数:
2014年06期
页码:
575-577
栏目:
出版日期:
2014-11-20

文章信息/Info

Title:
The predictive effect of Narcotrend monitor on consciousness recovery during emergence of general anesthesia combined with epidural block
作者:
余志阳1; 郑大东2; 刘清珍1; 徐苗苗1; 李伟彦1; 刘 健1; 朱四海1
210002 江苏南京，南京军区南京总医院，1.麻醉科,2.干部保健科
Author(s):
YU Zhi-yang1; ZHENG Da-dong2; LIU Qing-zhen1; XU Miao-miao1; LI Wei-yan1; LIU Jian1; ZHU Si-hai1.
1.Department of Anesthesiology，2.Department of Ranking Health- care,Nanjing General Hospital of Nanjing Military Command,Nanjing,Jiangsu 210002,China
关键词:
Narcotrend; 七氟烷; 意识; 血流动力学
Keywords:
Narcotrend;  sevoflurane;  consciousness;  hemodynamic
分类号:
R614
DOI:
10.3969/j.issn.1672-271X.2014.06.005
文献标志码:
A
摘要:
目的 观察Narcotrend麻醉深度监护仪对硬膜外复合七氟烷吸入麻醉患者苏醒期意识恢复的预测效果。方法 40例ASA Ⅰ～Ⅱ级在硬膜外复合全身麻醉下择期行肠道手术患 者，丙泊酚复合苏芬太尼靶控输注诱导，手术期间通过硬膜外镇痛、七氟烷镇静、顺式阿曲库铵肌肉松弛来维持麻醉。手术结束入麻醉恢复室，记录刺激无体动反应(T1)、呼之睁 眼(T2)、定向力恢复(T3)时Narcotrend指数(Narcotrend Index，NI)、七氟烷最低肺泡有效浓度(MAC)、平均动脉压(MAP)和心率(HR)，通过相关参数计算出上述参数对意识恢复的 预测概率(PK)。结果 硬膜外复合全身麻醉监测NI值能够预测苏醒期患者意识的改变。NI预测患者呼之睁眼时PK值为(0.76±0.07)，预测定向力恢复时PK值为(0.74±0.06)，高于 0.5(P＜0.05)，也高于MAP和HR的相应得预测概率PK值。苏醒期NI值与七氟烷MAC值的变化呈明显的负相关性，相关系数(r)为-0.896(P＜0.01)。 结论 Narcotrend能有效地反映硬 膜外复合全身麻醉下苏醒期患者意识水平的变化，其对苏醒期意识恢复的预测能力显著高于血流动力学指标。
Abstract:
Objective To evaluate the predictive effect of Narcotrend on consciousness recovery during the emergence of general anesthesia combined with epidural block.Methods Forty ASA Ⅰ or Ⅱ patients undergoing elective bowel surgery were anesthetized with general anesthesia combined with epidural block.Anesthesia was induced by target controlled infusion of propofol combined with sufentanil,and maintained by epidural analgesia,sevoflurane in sedation and cisatracurium in muscle relaxant.After surgery,the patients were transferred to the postanesthesia care unit (PACU),the values of NI (Narcotrend Index),minimum alveolar concentration (MAC) of sevoflurane,and hemodynamic parameters (MAP and HR) were recorded during the period of non-reaction to the stimulation (T1),at the time of eyes opening (T2) and orientation recovery (T3).The prediction probability (PK) of each parameter was calculated.Results NI were correlated well with the changes of consciousness during the emergence of general anesthesia combined with epidural block.PK values of NI in predicting eyes opening and orientation recovery were (0.76±0.07),(0.74±0.06),respectively,and were obviously higher than 0.5 and the PK values of MAP and HR (P<0.01).The values of NI were obvious negative correlated with MAC values of sevoflurane,and correlation coefficient was -0.896 (P<0.01).Conclusion Narcotrend monitor can be effectively used for predicting patients consciousness recovery during the emergence of general anesthesia combined with epidural block,however,the ability of prediction with Narcotrend on consciousness recovery was significantly higher than that of hemodynamic parameters.

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备注/Memo

备注/Memo:
南京军区医药卫生科研基金面上课题(12MA091)
更新日期/Last Update: 2014-11-20