标题：Narcotrend麻醉深度监测在无痛纤维支气管镜检查中的临床应用

      作者：黄锡强，苏圣贤，张志刚，林宏凯
    （中山市人民医院麻醉科，广东 中山 528403）

      卷次： 2013年24卷4期

      【摘要】 目的 在无痛纤支镜检查中使用Narcotrend (NT)监测麻醉深度，探讨其可行性及安全性。方法 60例
行无痛纤支镜检查的住院患者，随机并平均被分成A、B两组，均接受丙泊酚复合舒芬太尼全凭静脉麻醉，
其中A组为经验组，B组为NT组。A组患者接受麻醉医师根据经验调控麻醉深度；B组患者接受麻醉医师
根据NT值调控麻醉深度，以维持NT分级在D1~E0，NTI值为 27~56，分别记录两组患者设定时间点的生命
体征、麻醉及心血管活性药物用量、操作及苏醒时间、术中术后不良反应发生率，并由呼吸科医生对麻醉效果做
出评价。结果 两组患者相对应时段的心率、血压差异无统计学意义（P>0.05），麻醉后两对应时间点A组血氧饱
和度较B组低(P<0.05)，A组患者丙泊酚用量明显较B组多，苏醒时间明显较B组长（P<0.05），两组患者舒芬太尼用
量、心血管活性药物用量、操作时间、术后恶心呕吐发生发生率、术中知晓等情况差异均无统计学意义(P>0.05)，A组
发生体动呛咳较B组多(P<0.05)，两组患者麻醉效果B组明显优于A组（P<0.05）。结论 Narcotrend在无痛纤支
镜检查中对丙泊酚复合舒芬太尼全凭静脉麻醉深度进行监测，能降低低氧血症发生率，减少丙泊酚物用量，缩短
患者清醒时间，提高术者对麻醉效果的满意度。

      【关键词】 Narcotrend；麻醉深度；无痛纤支镜；全凭静脉麻醉；术中知晓

      【中图分类号】 R614 【文献标识码】 A 【文章编号】 1003—6350（2013）05—0514—03


Monitor the depth of anesthesia when using narcotrend during painless bronchoscopy.
HUANG Xi-qiang, SU
Sheng-xian, ZHANG Zhi-gang, LIN Hong-kai. Department of Anesthesiolog, People's Hospital of Zhongshan,
Zhongshan 528403, Guangdong, CHINA

【Abstract】 Objective To investigate the feasibility and safety of narcotrend during painless bronchoscopy,
and to monitor the depth of anesthesia. Methods Sixty hospitalized patients that undertook painless bronchoscopy
were divided randomly into two groups, with all of them undertook propofol combined with sufentanil total intrave-
nous anesthesia. Group A was the experience group and group B was NT group. The depth of anesthesia was con-
trolled by anaesthetist according to his experience in group A; the depth of anesthesia was controlled by anaesthetist
according to NT value in group B. The NT stage was maintained at D1~E0，NT index was maintained at 27~56. Vital
sigh of specific time points, anesthetic and cardiovascular active drugs amount, operation and recovery time, the inci-
dence of intraoperative and postoperative adverse reaction were recorded respectively, The effects of anesthesia were
evaluated by physicians specialized in respiratory. Results The differences in heart rate and blood pressure between the
two groups were not significant. At specific time point during anesthesia the oxygen saturation in group A was signifi-
cantly lower than that in group B (P<0.05). The consumption of propofol in group A was significantly more than that in
group B, the recovery time in group A was significantly longer than that in group B (P<0.05). There was no statistically
significant difference in the two groups of patients in the amount of sufentanil and cardiovascular active drugs, operation
time, as well as the incidence of postoperative nausea and vomiting, intraoperative awareness. The patients had more
cough and body movement in group A than that in group B, and the difference was statistically significant (P<0.05). The
effects of anesthesia in group A were generally better than that in group B (P<0.05). Conclusion Anesthesia depth
monitoring with narcotrend in painless bronchoscopy using total intravenous propofol combined with sufentanil, can
reduce hypoxemia incidence and the amount of propofol, shorten the recovery time, and improve the satisfaction of in-
traoperative anesthetic effect.

      【Key words】 Narcotrend; Depth of anesthesia;Painless bronchoscopy; Total intravenous anesthesia; Intraopera-
tive awareness
--------pianwei------
不同药物减少无痛胃镜检查中依托咪酯所致不良反应的效果比较
王启明，蒋 军，陈东明
（柳州市柳铁中心医院麻醉科，广西 柳州 545007）