發(fā)布時(shí)間：2018-06-22 14:15

  本文選題：意識(shí)指數(shù)監(jiān)測 + 丙泊酚　； 參考：《臨床麻醉學(xué)雜志》2015年07期

【摘要】：目的觀察意識(shí)指數(shù)(index of consciousness,IoC)監(jiān)測在無痛腸鏡檢查術(shù)中的臨床效果。方法選擇自愿行無痛腸鏡的男性患者200例,年齡18~65歲,隨機(jī)均分為觀察組(IoC組)和對(duì)照組(C組)。兩組患者均采用TCI丙泊酚復(fù)合瑞芬太尼麻醉,丙泊酚血漿靶濃度從4.0μg/ml起始,瑞芬太尼0.05μg·kg-1·min-1持續(xù)泵注。IoC組IoC指數(shù)保持在50±3,根據(jù)IoC值調(diào)整丙泊酚靶濃度;C組術(shù)中根據(jù)血流動(dòng)力學(xué)及體動(dòng)反應(yīng)調(diào)整麻醉深度。記錄給藥前即刻(T1)、睫毛反射消失(T2)、過脾曲(T3)、過肝曲(T4)和蘇醒時(shí)(T5)的MAP、HR、SpO2及鏡檢時(shí)間、丙泊酚用量、術(shù)后蘇醒時(shí)間、定向力恢復(fù)時(shí)間及正常行走時(shí)間,觀察術(shù)中不良反應(yīng)發(fā)生情況。結(jié)果與C組比較,IoC組丙泊酚用量明顯減少,蘇醒時(shí)間及定向力恢復(fù)時(shí)間明顯縮短(P0.05),體動(dòng)發(fā)生率明顯降低(P0.05)。兩組鏡檢時(shí)間、正常行走時(shí)間和呼吸抑制、頭暈、惡心嘔吐等不良反應(yīng)發(fā)生率差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 IoC監(jiān)測用于無痛腸鏡檢查術(shù)可減少麻醉藥物用量,縮短恢復(fù)時(shí)間。
[Abstract]:Objective to observe the clinical effect of (index of consciousness index IOC monitoring in painless enteroscopy. Methods 200 male patients, aged 18 to 65 years, who voluntarily underwent painless enteroscopy, were randomly divided into observation group (IOC group) and control group (C group). Both groups were anesthetized with propofol and remifentanil. The plasma target concentration of propofol began at 4.0 渭 g/ml. The IOC index of remifentanil 0.05 渭 g kg-1 min-1 continuous pump group was maintained at 50 鹵3. The anesthesia depth was adjusted according to the target concentration of propofol according to IOC value. The time of MAPHR-SPO _ 2, propofol dosage, recovery time, recovery time and normal walking time were recorded immediately before administration (T _ 1), disappearance of eyelash reflex (T _ 2), hypersplenic curvature (T _ 3), liver curvature (T _ 4) and recovery time (T _ 5). Results compared with group C, the dosage of propofol in IOC group was significantly reduced, the recovery time of recovery time and directional force were significantly shortened (P0.05), and the incidence of body movement was significantly decreased (P0.05). There was no significant difference in the incidence of adverse reactions such as microscopic examination time, normal walking time, respiratory depression, dizziness, nausea and vomiting between the two groups. Conclusion IOC monitoring for painless enteroscopy can reduce the dosage of anesthetic and shorten the recovery time.
【作者單位】： 南京中醫(yī)藥大學(xué)第二附屬醫(yī)院麻醉科;
【分類號(hào)】：R614

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