摘要
目的探讨意识指数(index of consciousness,Io C)监测在妇科腹腔镜靶控输注麻醉中的应用和意义。方法将2013年10月至2015年12月在常州市第一人民医院择期行靶控输注麻醉下的妇科腹腔镜手术者90例采用随机数字表法分为对照组和观察组,各45例,对照组采用传统的经验判定麻醉深度,观察组采用Io C监测判定麻醉深度。记录两组患者麻醉前(T0)、麻醉诱导后3 min(T1)、插管时(T2)、插管后2 min(T3)、拔管时(T4)的收缩压、舒张压和心率的变化以及Io C值,并记录两组患者的麻醉药物使用量、苏醒各项指标以及术中知晓发生率。结果两组患者在T1、T2、T3时的收缩压、舒张压及心率比T0时均显著降低,差异有统计学意义(P<0.05);观察组患者的丙泊酚用量明显少于对照组(P<0.05);观察组患者术后睁眼时间、合作评分>2分时间、清醒时间、拔管时间、恢复定向力时间以及出恢复室时间明显少于对照组,差异均有统计学意义(P<0.05);两组患者均无术中知晓发生。结论妇科腹腔镜靶控输注麻醉中采用Io C监测能准确指导麻醉深度的判断,并可有效减少术中丙泊酚的药量,缩短苏醒时间,降低麻醉恢复期风险。
Objective To explore the reliability and efficacy of index of consciousness （IoC） in gynecological laparoscopic surgery under target controlled infusion anesthesia without muscle relaxants. Methods 90 general anesthesia patients undergoing selective gynecological laparoseopic surgery in People＇ s 1st Hospital of Changzhou from October 2013 to December 2015 were randomly divided into control group （ n = 45 ） and observation group （ n = 45 ）. The control group used the traditional experience to determine the depth of anesthesia and the observation group used IoC to monitor the depth of anesthesia. Systolic blood pressure （ SBP）, diastolic blood pressure （DBP）, heart rate （HR） and IoC values were recorded at the beginning of TCI（ TO ）, during midazolam injecting（ T1 ）, intubation（ T2 ）, two minutes after intubation（ T3 ） , and extubation（ T4 ）. The consumption of propofol, recovery time, and intraoperative awareness were also recorded. Results SBP, DBP, HR at T1 .T2 ,T3 of two groups decreased than those at To, the differences were statistically significant （P 〈 0. 05）. Compared with control group, the consumption of propofol, recovery time, time of tube drawing and orientation recovery time were significantly lower in observation group, the differences were statistically significant （P 〈 0.05 ）. There were no intraoperative awareness in both groups. Conclusion IoC monitor enables patients in suitable anesthetic depth with reduced propofol consumption and fast recovery. It can reduce the risk duning anesthesia recovery period.
作者
李黎
陈晶辉
LI Li CHEN Jing- hui(Department of Anesthesiology, People＇s 1st Hospital of Changzhou, Changzhou Jiangsu 213000, P. R. China Department of Anesthesiology, Zaozhuang Hospital of Zaozhuang Minerals Group, Zaozhuang Shandong 277100, P. R. China)
出处
《中国计划生育和妇产科》
2016年第11期58-61,共4页
Chinese Journal of Family Planning & Gynecotokology
关键词
意识指数
麻醉深度
腹腔镜
靶控输注
index of consciousness
anesthetic depth
laparoscopic
target controlled infusion
