本文關(guān)鍵詞：Narcotrend盲法監(jiān)測下丙泊酚靶控輸注與恒速輸注靜脈全麻用于兒童纖支鏡肺泡灌洗術(shù)的比較　出處：《廣東醫(yī)學(xué)》2016年22期 　論文類型：期刊論文

  更多相關(guān)文章： 丙泊酚 靜脈麻醉 靶控輸注 支氣管肺泡灌洗術(shù) 小兒

【摘要】：目的對比研究Narcotrend盲法監(jiān)測下丙泊酚靶控輸注和恒速輸注復(fù)合靜脈麻醉用于小兒纖維支氣管鏡(簡稱纖支鏡)肺泡灌洗術(shù)的臨床效果,探討適合小兒靜脈麻醉的優(yōu)化方案。方法將40例支氣管肺炎擇期接受纖支鏡肺泡灌洗術(shù)的患兒隨機(jī)分為兩組:靶控輸注組(TCI組)和恒速輸注組(CI組),每組20例,全部患兒入室后即安放Narcotrend腦電監(jiān)測及檢測心電圖(ECG)、心率(HR)、平均動(dòng)脈壓(MAP)、呼吸(RR)及食指末梢血氧飽和度(Sp O2)。Narcotrend腦電監(jiān)測屏幕遮擋,數(shù)值由專人監(jiān)控記錄,保持麻醉管理者全程不會(huì)觀察到Narcotrend指數(shù)(Narcotrend index,NI)。觀察記錄麻醉前、手術(shù)開始及術(shù)中、術(shù)畢的NI、MAP、HR、ECG、Sp O2,手術(shù)過程中兩組患兒發(fā)生90%≤Sp O295%超過30 s而需要退鏡至主氣管并暫停手術(shù)的次數(shù);Sp O290%超過30 s而必須完全退出纖支鏡輔助呼吸的次數(shù);并統(tǒng)計(jì)麻醉總時(shí)間、手術(shù)總時(shí)間、蘇醒時(shí)間(從停藥開始到蘇醒評分達(dá)6分)及蘇醒期并發(fā)癥。結(jié)果與CI組相比,TCI組術(shù)中血壓下降較明顯,患兒術(shù)中缺氧發(fā)生率較低(P0.01);TCI組在5 min的蘇醒評分與CI組差異有統(tǒng)計(jì)學(xué)意義(P0.05),1 min和10 min評分差異無統(tǒng)計(jì)學(xué)意義(P0.05)。NI在CI組表現(xiàn)出較大波動(dòng);CI組有4例出現(xiàn)蘇醒期煩躁,1例出現(xiàn)術(shù)中知曉,TCI組無相關(guān)并發(fā)癥發(fā)生(P0.05),麻醉和手術(shù)時(shí)間兩組間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論丙泊酚靶控輸注靜脈麻醉用于小兒纖支鏡肺泡灌洗術(shù),可產(chǎn)生穩(wěn)定的效應(yīng)室藥物濃度,較傳統(tǒng)的恒速輸注法可以更好地維持麻醉過程中患者腦電意識(shí)深度的穩(wěn)定性,提示麻醉效果更平穩(wěn),麻醉蘇醒質(zhì)量更好,是一種值得推薦的麻醉方式,同時(shí)也表明腦電意識(shí)深度監(jiān)測用于指導(dǎo)臨床麻醉深度的控制具有積極意義。
[Abstract]:Objective to compare the clinical effects of target-controlled infusion of propofol and intravenous anesthesia with constant velocity infusion under Narcotrend blind monitoring for bronchofiberscope alveolar lavage in children. Methods 40 children with bronchopneumonia undergoing bronchoalveolar lavage were randomly divided into two groups: target controlled infusion group (TCI group) and constant-rate infusion group (TCI group). Group CI). All the 20 cases in each group were placed Narcotrend EEG monitoring, electrocardiogram (ECG), heart rate (HR) and mean arterial pressure (ABP) immediately after entering the room. Respiratory RR) and index finger peripheral blood oxygen saturation (SPO _ 2O _ 2). Narcotrend EEG monitor screen occlusion, the value of monitoring by a special person to record. The Narcotrend index Narcotrend index was not observed throughout the course of anesthesia. The NI was recorded before, during and after operation. During the operation, 90% 鈮，

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