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Narcotrend分级指导下丙泊酚靶控输注对耳鼻喉科手术患者拔管时机的影响
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| 篇名： | Narcotrend分级指导下丙泊酚靶控输注对耳鼻喉科手术患者拔管时机的影响 |
| TITLE： | |
| 摘要： | 目的：探讨Narcotrend分级指导下丙泊酚靶控输注对耳鼻喉科手术患者拔管时机的影响。方法：52例静脉全身麻醉下行耳鼻喉科微创手术患者均给予丙泊酚靶控输注进行麻醉诱导和麻醉维持。记录所有患者麻醉前、苏醒期各时间点镇静深度指数（NI）、丙泊酚血药浓度（cm）、平均动脉压（MAP）、血氧饱和度（SpO2），以及拔管时患者的NI、丙泊酚cm，分析拔管时NI与丙泊酚cm、拔管时间的相关性。结果：麻醉前、苏醒期各时间点SpO2比较，差异均无统计学意义（P＞0.05）；T3时MAP显著高于麻醉前，T0～T1时MAP显著低于麻醉前，丙泊酚cm T0＞T1＞ T2＞T3＞T4＞T5，T0～T3时NI均显著低于麻醉前，且T0＜T1＜T2＜T3，差异均有统计学意义（P＜0.05）；T4～T5时与麻醉前比较，差异均无统计学意义（P＞0.05）。拔管时NI为（86.17±5.29），丙泊酚cm为（0.96±0.31）μg/ml，平均拔管时间为（8.26±2.93）min。拔管时，NI与丙泊酚cm呈负相关（r＝－0.812）；NI与拔管时间呈负相关（r＝－0.792）；NI、丙泊酚cm在苏醒期预测意识变化的预测率分别为0.93和0.86。所有患者用药期间均未见明显不良反应发生。结论：Narcotrend分级指导下丙泊酚靶控输注，能准确地预测患者从对刺激无反应到呼之睁眼的意识变化，有利于正确选择拔管的时机，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To explore the effect of propofol target-controlled infusion on extubation time in patients with ENT surgery under Narcotrend classification guidance. METHODS： 52 patients with endotracheal intubation intravenous anesthesia and minimally invasive ENT surgery received target-controlled infusion for anesthesia induction and anesthesia. NI value， plasma concentration of propofol （cm）， mean arterial pressure （MAP）， pulse oxygen saturation （SpO2） before anesthesia and different time points in recovery period， the correlation of NI with propofol cm of all patients were recorded，and NI with propofol cm and time when extubation was omalysed. RESULTS： There were no significant differences in SpO2 before anesthesia and different time points in recovery period （P＞0.05）； MAP was significantly higher than before anesthesia at T3， MAP was significantly lower than before anesthesia at T0-T1， propofol cm was T0＞T1＞T2＞T3＞T4＞T5， NI was significantly lower than before anesthesia at T0-T3， and T0＜T1＜T2＜T3， the differences were statistically significant （P＜0.05）， and there were no significant differences between T4-T5 and before anesthesia （P＞0.05）. NI when extubation was（86.17±5.29）， propofol cm was （0.96±0.31） μg/ml， and average extubation time was （8.26±2.93） min. When extubation， NI showed negative correlation with propofol cm（r＝－0.812）； and decreased with the prolong of extubation time （r＝－0.792）； the predictive rates of NI and propofol cm's prediction awareness change in recovery period were 0.93 and 0.86. There were no obvious adverse reactions during treatment. CONCLUSIONS： Propofol target-controlled infusion under Narcotrend classification guidance can accurately predict the awareness change from no response to stimuli to shouting and opening eyes， has a high reference value on extubation time. |
| 期刊： | 2016年第27卷第24期 |
| 作者： | 张培俊，唐珩，王莉，李艳华 |
| AUTHORS： | ZHANG Peijun，TANG Heng，WANG Li，LI Yanhua |
| 关键字： | Narcotrend分级指导；丙泊酚；靶控输注；拔管时机 |
| KEYWORDS： | Narcotrend classification guidance； Propofol； Target-controlled infusion； Extubation opportunity |
| 阅读数： | 223 次 |
| 本月下载数： | 3 次 |
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