本文選題：Narcotrend + 老年病人��； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的：觀察Narcotrend腦電監(jiān)測(cè)在老年骨科手術(shù)患者中的應(yīng)用效果，為老年骨科手術(shù)全麻患者提供合理的麻醉方法。 方法：選擇自2013年7月~2014年3月全身麻醉下行擇期骨科手術(shù)的老年患者，年齡65~80歲之間，所有手術(shù)患者均在全憑靜脈麻醉下完成手術(shù)，術(shù)中麻醉維持以丙泊酚復(fù)合瑞芬太尼恒速輸注，病人隨機(jī)分為Narcotrend組（NT組，麻醉調(diào)節(jié)依據(jù)Narcotrend值）和對(duì)照組（C組，依據(jù)患者生命體征的變化，麻醉醫(yī)生憑借個(gè)人臨床經(jīng)驗(yàn)進(jìn)行麻醉深度的調(diào)節(jié)），每組患者30例。術(shù)中記錄兩組患者T1（麻醉誘導(dǎo)前10min）、T2（麻醉誘導(dǎo)后）、T3（氣管插管后）、T4（手術(shù)開始時(shí)）、T5（手術(shù)結(jié)束時(shí)）、T6（拔除氣管導(dǎo)管）、T7（入PACU）、T8（出PACU）8個(gè)時(shí)間點(diǎn)的平均動(dòng)脈壓（mean arterial pressure，MAP），心率（heart rate，HR）。并記錄兩組患者的手術(shù)時(shí)間，，麻醉時(shí)間，蘇醒時(shí)間，拔管時(shí)間，PACU觀察時(shí)間，麻醉維持藥物丙泊酚，瑞芬太尼，血管活性藥物的總劑量，術(shù)后24小時(shí)記錄患者的術(shù)中知曉情況，術(shù)后惡心、嘔吐發(fā)生情況。 結(jié)果：NT組患者在各時(shí)間點(diǎn)的MAP,HR與對(duì)照組比較無(wú)統(tǒng)計(jì)學(xué)差異，兩組患者術(shù)中血流動(dòng)力學(xué)平穩(wěn)。兩組患者在手術(shù)時(shí)間及麻醉時(shí)間上比較無(wú)統(tǒng)計(jì)學(xué)差異。NT組患者蘇醒時(shí)間，拔管時(shí)間及出PACU時(shí)間與對(duì)照組比較具有統(tǒng)計(jì)學(xué)差異，p0.05。NT組在整個(gè)手術(shù)過(guò)程中，丙泊酚總劑量，瑞芬太尼總劑量及去甲腎上腺素的劑量與對(duì)照組比較均明顯減少，P0.05具有統(tǒng)計(jì)學(xué)差異。兩組患者術(shù)后均無(wú)術(shù)中知曉的發(fā)生，惡心、嘔吐的并發(fā)癥無(wú)統(tǒng)計(jì)學(xué)差異。 結(jié)論：Narcotrend腦電監(jiān)測(cè)儀應(yīng)用于老年骨科病人的手術(shù)術(shù)中監(jiān)測(cè)，能夠明顯地減少術(shù)中丙泊酚及瑞芬太尼的用量，明顯地縮短術(shù)后清醒及拔管時(shí)間，使停留在PACU時(shí)間更短，更有利于老年患者的麻醉管理。
[Abstract]:Objective: to observe the effect of Narcotrend EEG monitoring in elderly patients undergoing orthopaedic surgery, and to provide a reasonable anesthetic method for general anesthesia patients undergoing orthopaedic surgery.Methods: elderly patients with elective orthopedic surgery under general anesthesia from July 2013 to March 2014 were selected, aged between 65 and 80 years. All the patients underwent the operation under total intravenous anesthesia.The patients were randomly divided into Narcotrend group (NT group) and control group (C group according to the Narcotrend value), according to the changes of vital signs, the patients were given intraoperative anesthesia with propofol combined with remifentanil at constant rate.The anesthesiologist, with his own clinical experience, adjusts the depth of anesthesia in 30 patients in each group.T1 (10 min before anesthesia induction) and T2 (T3 after anesthesia induction) were recorded in both groups. The mean arterial pressure (mean arterial pressureMAPP, heart rate, heart rate) was observed at the beginning of the operation (T6) at the end of the operation.The operation time, anaesthesia time, recovery time, extubation time and PACU observation time, the total dose of propofol, remifentanil and vasoactive drugs were recorded.Postoperative nausea and vomiting occurred.Results there was no significant difference in MAPHR between the two groups at different time points. The hemodynamics of the two groups was stable during operation.There was no significant difference in the operation time and anesthesia time between the two groups. The recovery time, extubation time and PACU time of the NT group were significantly different from those of the control group. The total dose of propofol in the whole operation process of the NT group was significantly different from that of the control group.The total dose of remifentanil and the dose of norepinephrine were significantly decreased compared with the control group (P0.05).There was no significant difference in complications of nausea and vomiting between the two groups.Conclusion the application of the 10% Narcotrend EEG monitor in operative monitoring of senile orthopedic patients can significantly reduce the dosage of propofol and remifentanil during operation, shorten the time of postoperative wake up and extubation, and make the time of staying in PACU shorter.It is more beneficial to the anaesthesia management of the elderly patients.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 孫永鋒;馮春;婁曄;;腦功能狀態(tài)指數(shù)(CSI)在全麻中作為鎮(zhèn)痛深度監(jiān)測(cè)的實(shí)驗(yàn)研究[J];當(dāng)代醫(yī)學(xué);2010年21期

2 李天佐;;老年人下肢骨科手術(shù)麻醉選擇與管理[J];北京醫(yī)學(xué);2013年08期

3 張宏;畢素萍;賈寶森;;熵指數(shù)監(jiān)測(cè)在全憑靜脈麻醉誘導(dǎo)期中的應(yīng)用[J];軍醫(yī)進(jìn)修學(xué)院學(xué)報(bào);2008年02期

4 王云;岳云;;麻醉深度監(jiān)測(cè)的進(jìn)展和展望[J];繼續(xù)醫(yī)學(xué)教育;2006年15期

5 陳杰,王祥瑞,杭燕南,孫大金;不同靜脈麻醉藥對(duì)聽覺誘發(fā)電位指數(shù)的影響[J];臨床麻醉學(xué)雜志;2002年12期

6 米衛(wèi)東,劉靖,曹江北,張宏;腦電雙頻指數(shù)與聽覺誘發(fā)電位指數(shù)監(jiān)測(cè)誘導(dǎo)期麻醉深度的比較[J];臨床麻醉學(xué)雜志;2004年09期

7 徐暉;郭錫恩;金孝\

本文編號(hào)：1769381