彭晓东, 吴庆玲, 郑立东, 李家宽. Narcotrend分级指导下丙泊酚靶控输注用于高血压患者麻醉的临床观察[J]. 蚌埠医科大学学报, 2015, 40(4): 467-469. DOI: 10.13898/j.cnki.issn.1000-2200.2015.04.016
    引用本文: 彭晓东, 吴庆玲, 郑立东, 李家宽. Narcotrend分级指导下丙泊酚靶控输注用于高血压患者麻醉的临床观察[J]. 蚌埠医科大学学报, 2015, 40(4): 467-469. DOI: 10.13898/j.cnki.issn.1000-2200.2015.04.016
    PENG Xiao-dong, WU Qing-ling, ZHENG Li-dong, LI Jia-kuan. Clinical observation of propofol target controlled infusion guided by Narcotrend stages in the anesthesia of hypertension patients[J]. Journal of Bengbu Medical University, 2015, 40(4): 467-469. DOI: 10.13898/j.cnki.issn.1000-2200.2015.04.016
    Citation: PENG Xiao-dong, WU Qing-ling, ZHENG Li-dong, LI Jia-kuan. Clinical observation of propofol target controlled infusion guided by Narcotrend stages in the anesthesia of hypertension patients[J]. Journal of Bengbu Medical University, 2015, 40(4): 467-469. DOI: 10.13898/j.cnki.issn.1000-2200.2015.04.016

    Narcotrend分级指导下丙泊酚靶控输注用于高血压患者麻醉的临床观察

    Clinical observation of propofol target controlled infusion guided by Narcotrend stages in the anesthesia of hypertension patients

    • 摘要: 目的:观察Narcotrend(NT)指导下丙泊酚靶控输注用于高血压患者麻醉的临床效果。方法:合并原发性高血压1~2级行腹腔镜胆囊切除术患者50例,随机均分为观察组(N组)和对照组(C组)。N组依据患者NT分级(NTS)调控丙泊酚靶浓度,使NTS维持在D2~E0水平;C组依据患者的平均动脉压(MAP)、心率(HR)调控丙泊酚靶浓度,维持MAP波动不超过基础值±20%、HR 55~100次/分;2组丙泊酚均在2~5 μg/ml范围内调整。若2组麻醉深度调整后MAP、HR超出范围,则给予心血管活性药物干预。记录2组麻醉时间、手术时间、苏醒时间、拔管时间,丙泊酚和舒芬太尼的用量,心血管活性药物使用情况以及苏醒期躁动、恶心呕吐、术中知晓等发生率。结果:与C组比较,N组苏醒时间和拔管时间均相应缩短(P<0.05和P<0.01),丙泊酚用量显著减少(P<0.01); C组乌拉地尔使用率多于N组(P<0.05);2组苏醒期躁动和恶心呕吐发生率差异均无统计学意义(P>0.05)。结论:NTS指导下丙泊酚靶控输注在高血压患者麻醉中的应用,可以使麻醉深度更易于掌控,血流动力学更为稳定,复苏时间缩短,有利于实现精确麻醉,在确保麻醉安全、提高麻醉质量方面更具有优越性。

       

      Abstract: Objective:To observe the clinical effects of propofol target controlled infusion guided by Narcotrend(NT) stages in the anesthesia of hypertension patients.Methods:Fifty 1 to 2 level primary hypertension patients treated with laparoscopic cholecystectomy were randomly divided into the observation group(group N) and control group(group C).The concentration of propofol was adjusted according to NT stages(NTS) in group N, which can maintain NTS at D2 to E0 level.The concentration of propofol in group C was adjusted according to mean arterial pressure(MAP) and HR, which can maintain MAP fluctuations at no more than ±20% of baseline and HR at 55 to 100 beats/min.The concentration of propofol in both groups were adjusted in the range of 2 to 5 μg/ml.The cardiovascular drugs were used to intervene when the MAP and HR in two groups were out of range after adjusting the depth of anesthesia.The anesthesia time, operation time, analepsia time, extubation time and dosages of propofol and sufentanil in two groups were recorded.The cardiovascular drug use and incidences of dysphoria, nausea, vomiting and intraoperative awareness in two groups were also recorded.Results:Compared with group C, the analepsia time and extubation time in group N were shortened(P<0.05 and P<0.01), and the dosage of propofol in group N decreased significantly(P<0.01).The Urapidil use in group C was more than that in group N(P<0.05).The differences of the incidences of dysphoria, nausea and vomiting between two groups were not statistically significant(P>0.05).Conclusions:The application of propofol target controlled infusion guided by NTS in the anesthesia of hypertension patients can control the anesthetic depth, maintain stable hemodynamics, shorten recovery time, conducive to the realization of accurate anesthesia, ensure the safety of anesthesia and improve the quality of anesthesia.

       

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