本文選題：Narcotrend + 麻醉深度　； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的：本研究目的是探討Narcotrend監(jiān)測應(yīng)用于不同年齡段全麻患者蘇醒情況比較。 方法：選取吉林大學(xué)白求恩第一醫(yī)院2013年12月~2014年2月?lián)衿谛腥砺樽硐赂骨荤R胃癌根治術(shù)患者100名，ASAI或II級，A組為年齡65~80歲患者50名，B組為年齡40~64歲患者50名。把A組患者按照隨機(jī)表格法分成2組：A1組（Narcotrend監(jiān)測組，n=25），A2組（對照組，n=25），把B組患者按照隨機(jī)表格法分成2組：B1組（Narcotrend監(jiān)測組，n=25），B2組（對照組，n=25）。在A1和B1組，手術(shù)過程中將Narcotrend值控制在D2（46~37）期，A2和B2組患者進(jìn)行Narcotrend監(jiān)測，但施麻醉者無法看到Narcotrend數(shù)值，根據(jù)臨床經(jīng)驗(yàn)進(jìn)行術(shù)中管理�；颊呷胧液蟪Ｒ�(guī)監(jiān)測BP、HR、SPO2，麻醉誘導(dǎo)設(shè)定丙泊酚初始效應(yīng)室濃度3.5μg ml，靶控輸注丙泊酚2-4μg ml和瑞芬太尼6-8g kg h進(jìn)行麻醉維持，，縫合皮膚時(shí)停止丙泊酚的輸注。記錄不同時(shí)間點(diǎn)Narcotrend值、平均動脈壓(MAP)、心率(HR)、丙泊酚效應(yīng)室濃度，不同時(shí)間點(diǎn)分別為基礎(chǔ)值（T1），氣管插管前1min（T2），氣管插管后即刻（T3），打入氣腹前1min（T4），打入氣腹后即刻（T5），手術(shù)結(jié)束時(shí)（T6）。分別比較A1、A2組和B1、B2組患者蘇醒時(shí)間。 結(jié)果：A1組患者蘇醒時(shí)間明顯小于A2組，B1組與B2組相比患者蘇醒時(shí)間無臨床意義。 結(jié)論：應(yīng)用Narcotrend監(jiān)測能減少丙泊酚的用量，縮短老年患者蘇醒時(shí)間，對縮短年輕患者蘇醒時(shí)間無臨床意義。
[Abstract]:Objective: to explore the comparison of Narcotrend monitoring in patients with general anesthesia in different age groups. Methods: from December 2013 to February 2014, 100 patients with gastric cancer undergoing laparoscopic radical gastrectomy under general anesthesia in Bai Qiuen first Hospital of Jilin University were selected as group A and group A: 50 patients aged 65 to 80 years old, group B: 50 patients aged 40 to 64 years. The patients in group A were randomly divided into two groups according to the random table method: 1: 1 group Narcotrend monitoring group (control group) and group B (control group) were divided into two groups according to the random table method: group B, Narcotrend monitoring group (group B), group B (control group), group B (n = 25). In group A1 and group B1, the Narcotrend value was controlled at D _ 2 ~ (46 ~ (37) during operation. The patients in group A _ 2 and group B _ 2 were monitored for Narcotrend, but the anesthesiologist could not see the value of Narcotrend and managed it according to the clinical experience. BPHR-SPO _ 2 was routinely monitored after anesthesia induction, the initial concentration of propofol was set at 3.5 渭 g / ml, the target controlled infusion of propofol 2-4 渭 g / ml and remifentanil 6-8 g / kg / h were used for anesthesia maintenance, and the infusion of propofol was stopped during skin suture. The Narcotrend values, mean arterial pressure, heart rate, propofol effect chamber concentration were recorded at different time points, respectively. At different time points, the baseline values were T _ 1, T _ 2, T _ 3, T _ 3, T _ 5 and T _ 5 immediately before pneumoperitoneum and pneumoperitoneum, respectively, at the end of operation. The recovery time of A _ 1 A _ 2 group and B _ 1 B _ 2 group were compared. Results there was no clinical significance between group A 1 and group B 2 when compared with group B 2. The recovery time of group A 1 was significantly shorter than that of group B 1. Conclusion: Narcotrend monitoring can reduce the dosage of propofol, shorten the recovery time of elderly patients, and has no clinical significance in shortening the recovery time of young patients.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R614.2

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