作　　者： (）;

机构地区： 中山大学附属东华医院

出　　处： 《广西医学》 2019年第22期2879-2882,共4页

摘　　要： 目的观察Narcotrend监测下不同麻醉深度对老年腹腔镜疝修补术患者苏醒质量的影响。方法将全身麻醉下行腹腔镜疝修补术的59例老年患者随机分为A组(n=30)和B组(n=29)。A组患者术中Narcotrend分级维持在D0水平,B组患者维持在D2水平。比较两组患者自主呼吸恢复时间、苏醒时间、拔管时间和Steward苏醒评分大于4分的时间,分别于拔管后即刻(T1)、拔管后5 min(T2)、15 min(T3)、30 min(T4)对两组患者进行改良警觉/镇静评分及Steward苏醒评分,并记录两组患者苏醒期躁动及术中知晓情况。结果 A组自主呼吸恢复时间、苏醒时间、拔管时间及Steward苏醒评分大于4分的时间均短于B组(均P<0.05);A组T1、T2时改良警觉/镇静评分以及T1时Steward苏醒评分均高于B组(均P<0.05);所有患者均无术中知晓,两组苏醒期躁动发生率差异无统计学意义(P>0.05)。结论将Narcotrend监测分级维持在D0水平,有助于缩短老年腹腔镜疝修补术患者的苏醒时间,提高苏醒质量,且不增加苏醒期躁动发生率。 Objective To observe the effects of different depths of anesthesia monitored by Narcotrend on the quality of recovery in elderly patients undergoing laparoscopic hernioplasty.Methods Fifty-nine elderly patients receiving laparoscopic hernioplasty under general anesthesia were randomly divided into group A(30 cases) and group B(29 cases).Narcotrend grade was maintained at D0 level in group A and D2 level in group B.The duration for occurrence of spontaneous breathing,duration for recovery,duration for extubation,and duration for Steward recovery score greater than 4 points were compared between the two groups;Modified Observer′s Assessment Alertness and Sedation(OAA/S) score and Steward recovery score were assessed at the instant of extubation(T1),5 minutes(T2),15 minutes(T3) and 30 minutes(T4) after extubation;the incidence of restlessness during recovery and intraoperative awareness were recorded in both groups.Results The duration for occurrence of spontaneous breathing,duration for recovery,duration for extubation,and duration for Steward recovery score greater than 4 points were shorter in group A than those in group B(all P<0.05);the modified OAA/S score at T1 and T2,as well as Steward recovery score at T1 were higher in group A than those in group B(all P<0.05);no intraoperative awareness occurred in any patients,and there was no statistically significant difference in the incidence rate of restlessness between the two groups(P>0.05).Conclusion Maintaining Narcotrend monitoring grade at D0 level is more conducive to shortening the duration of recovery in the elderly patients undergoing laparoscopic hernioplasty,and improving the quality of recover without increasing incidence rate of restlessness during recovery.

关 键 词： 监测 麻醉深度 腹腔镜疝修补术 老年人 苏醒质量 苏醒时间 躁动

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