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目的评价Narcotrend(NT)在婴幼儿临床麻醉中应用的安全性和可行性。方法选择拟行腹部手术的患儿120例,年龄1～3岁,ASA分级Ⅰ～Ⅱ级,随机分为2组,每组各60例。Ⅰ组:七氟烷、瑞芬太尼和罗库溴铵维持麻醉;Ⅱ组:异丙酚、瑞芬太尼和罗库溴铵维持麻醉。采用NT监测麻醉深度,将NT控制在60±5,记录麻醉诱导前到手术探查期间不同时点的血流动力学参数及苏醒、拔管时间。结果Ⅱ组苏醒迅速、完全,苏醒时间与Ⅰ组比较有统计学差异(P<0.05)。术中2组在麻醉诱导时(NT为97±3)BP、HR明显低于麻醉前水平(P均<0.05);插管即刻(NT为60±5)BP、HR明显上升;其后各时点(插管后5min、切皮即刻、切皮后5min及腹腔探查时)NT均为60±5,除切皮后5minⅡ组BP低于Ⅰ组(P<0.05),术中2组的HR、BP都很平稳。结论 NT作为婴幼儿麻醉深度的监测指标具有一定临床意义。
Objective To evaluate the safety and feasibility of Narcotrend (NT) in the clinical anesthesia of infants and young children. Methods Totally 120 children (1-3 years old) with ASA grade Ⅰ ~ Ⅱ were enrolled in this study. They were randomly divided into 2 groups (60 in each group). Group Ⅰ: sevoflurane, remifentanil and rocuronium maintained anesthesia; group Ⅱ: propofol, remifentanil and rocuronium to maintain anesthesia. NT was used to monitor the depth of anesthesia, NT was controlled at 60 ± 5, recorded before anesthesia induction to surgical exploration at different points during the hemodynamic parameters and wake up, extubation time. Results The recovery of group Ⅱ was rapid and complete, and the recovery time was significantly different from that of group Ⅰ (P <0.05). During the induction of anesthesia (NT 97 ± 3) BP, the HR of the two groups were significantly lower than those before anesthesia (all P <0.05); immediately after intubation (NT 60 ± 5) BP, HR increased significantly The time points (5 min after intubation, immediate incision, 5 min after incision, and peritoneal exploration) were all 60 ± 5, and the BP of group Ⅱ was lower than that of group Ⅰ at 5 min after incision (P <0.05) HR, BP are very stable. Conclusion NT as a monitoring indicator of anesthesia in infants and young children has some clinical significance.