麻醉深度指数和Narcotrend指数的临床应用比较

来源 :国际麻醉学与复苏杂志 | 被引量 : 0次 | 上传用户:f372286882
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目的:探讨麻醉深度指数(depth of anesthesia index, AI)在全凭静脉麻醉中的应用,并与Narcotrend指数(Narcotrend Index, NI)进行比较。方法:择期全身麻醉下行支撑喉显微镜手术的患者40例,年龄18~65岁,ASA分级Ⅰ、Ⅱ级,同时监测患者AI、NI及丙泊酚效应室浓度(effect-site concentration, Ce)。麻醉诱导气管插管后,持续泵注丙泊酚、瑞芬太尼、米库氯铵维持麻醉。记录数据信号稳定后(Tn 1)、诱导前(Tn 2)、插管前(Tn 3)、插管后1 min(Tn 4)、插管后3 min(Tn 5)、插管后5 min(Tn 6)、置喉镜前(Tn 7)、置喉镜后1 min(Tn 8)、置喉镜后5 min(Tn 9)、手术结束(Tn 10)、苏醒(Tn 11)、拔管(Tn 12)12个时点的AI、NI、Ce。n 结果:随着麻醉深度的变化,AI和NI的变化趋势一致。AI与NI、Ce的相关系数分别为0.913(n P<0.05 )、-0.599(n P<0.05),NI和Ce的相关系数为-0.584(n P<0.05),AI、NI、Ce三者具有良好的相关性。n 结论:AI和NI均能准确反映患者手术不同阶段的麻醉深度,AI监测用于全凭静脉麻醉可较好地控制麻醉深度,指导合理用药,避免患者术中知晓。“,”Objective:To explore the application of depth of anesthesia index (AI) during total intravenous anesthesia, and compare it with Narcotrend Index (NI).Methods:Choosing 40 cases of patients who underwent laryngeal surgery under general anesthesia, aged 18-65, American Society of Andrology (ASA) Ⅰ to Ⅱ. The AI, NI and propofol effect-site concentrations (Ce) of patients were monitored simultaneously. After intubation, propofol, remifentanil and mivacurium were continuously infused to maintain adequate depth of anesthesia. The AI, NI, and Ce were recorded at the time points of stable signals began to show up (Tn 1), before the induction (Tn 2), before intubation (Tn 3), 1 min after intubation (Tn 4), 3 min after intubation (Tn 5), 5 min after intubation (Tn 6), before placing the laryngoscopy (Tn 7), 1 min after placing the laryngoscopy (Tn 8), 5 min after placing the laryngoscopy (Tn 9) end of the surgery (Tn 10), arousal (Tn 11) and extubation (Tn 12).n Results:As the depth of anesthesia changes, the trends of AI and NI are consistent. The correlation coefficients of AI, NI and Ce are 0.913, -0.599, the correlation coefficients of NI and Ce is -0.584. The changing tendencies of AI、NI and Ce correlated well to each other.Conclusions:Both AI and NI can reflect the depth of anesthesia of patients at different stages of the operation accurately. The application of AI monitoring during intravenous anesthesia can better control the depth of anesthesia, guide the rational use of medication, and avoid the patient's intraoperative awareness.
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