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Objective: To compare the sedation induced by target-controlled infusion of propofol with that by propofol-remifentanil in third molar exaction surgery. Methods: 60 patients for third molar exaction were divided randomly into 2 groups(n = 30): group P(propofol group) and group PR(propofol-remifentanil group). In group P,a titrated infusion of propofol was started until the OAA/S score had reached level 3 in the patients,then the surgery began. In group PR,a infusion of remifentanil with a target plasma concentration of 1 ng /ml and a titrated infusion of propofol was started until the OAA/S score had reached level 3,then the surgery began. In all patients,the heart rate,blood pressure,respiratory rate,oxyhemoglobin saturation and narcotrend index were recorded during the operation. The reactions of the patients in the operation were recorded. The satisfaction of the patients and surgeons was asked. Results: The respiratory rate and the oxyhemoglobin saturation in group PR was lower than those in group P(P ＜ 0. 05). No obvious adverse reaction was observed in the 2 groups. The satisfaction of the patients in the 2 groups was 30 /30 and 30 /30(P＞ 0. 05). Conclusion: The sedation induced by target-controlled infusion of propofol or propofol-remifentanil in third molar extraction is safe. The sedation under target-controlled infusion of propofol-remifentanil is better than that by propofol when inhalating oxygen.
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Objective The aim of this study is to compare sedation titrated under target-controlled infusion of propofol and propofol-remifentanil for impacted supernumerary teeth extraction surgery for children. Methods A total of 60 children with anterior maxillary region impacted supernumerary teeth extraction surgery were divided randomly into two groups, namely, propofol group (group P, n=30) and propofol-remifentanil group (group PR, n=30). In group P, a titrated infusion of propofol was started until the modified observer's assessment of alertness/sedation (OAA/S) scale reached level 3 before the actual surgery. In group PR, a remifentanil infusion with a target plasma concentration of 1 ng·mL⁻¹ was started until the operation was finished. A titrated infusion of propofol was also started until the modified OAA/S score reached level 3 before the actual surgery. The Houpt behavior scale was adopted to evaluate the cooperation of each patient in both groups. The heart rate, blood pressure, respiratory rate, oxyhemoglobin saturation, and Narcotrend index, complications, adverse reactions and propofol infusion of all patients were recorded during the operation. Results The Houpt behavior scales in group PR were better than those in group P (P<0.05). The oxyhemoglobin saturation and respiratory rate in group PR were lower than that in group P (P<0.05). The heart rate, blood pressure and NI in two groups were no significant difference (P>0.05). The incidence of respiratory depression and anterograde amnesia in group PR were higher than that in group P (P<0.05). Conclusion Sedation titrated under the target-controlled infusion of propofol and that titrated under propofol-remifentanil for impacted supernumerary teeth extraction surgery for children are safe. The sedation titrated under target-controlled infusion of propofol-remifentanil is better than sedation by propofol when inhaling oxygen.
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Objective To investigate the effects of different depths of anesthesia on incidence of postopera-tive cognitive dysfunction (POCD). Methods We systematically retrievedPubmed,OVID,CNKI,CBM and Wanfang database and VIP database for randomized controlled trials(RCTs)from inceptionto December 312016, comparing different depths of anesthesia for their impacts on incidence of early POCD. After data extraction and quality evaluation,Revman 5.3 software was used for statistical data analysis. Results A total of 714 patients in 8 eligible RCTs were identified. Results of meta-analysis were as follows.(1)Incidence of POCD of depth anesthesia (NTS=E0-E1)was lower than general anesthesia(NTS=D0-D1)1 d after surgery(OR=0.21,95%CI 0.13~0.35,P < 0.00001).(2)Incidence of POCD of depth anesthesia(NTS = E1)was lower than general anesthesia (NTS=D0)7 d after surgery(OR=0.45,95%CI 0.23~0.91,P=0.03).(3)Incidence of POCD of NTS=E1 was lower than NTS=D07d after surgery(OR=0.42,95%CI 0.24~0.71,P=0.001). Conclusion Comparedwith general anesthesia,depth anesthesia is associated with a lower incidence of early POCD.
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Objective To observe intravenous lidocaine in patients undergoing hysteroscopy surgery under Narcotrend monitoring. Methods 80 patients undergoing elective hysteroscopy surgery were randomly divided into normal saline group(group S)and lidocaine group(group L). Before anesthesia induction ,group L was given lido-caine injection of 1.5 mg/kg,then with 2 mg/(kg·h)for infusion to the end of surgery. Group S received normal sa-line instead of lidocaine as the control. All patients received Narcotrend(NT)monitoring anesthesia depth of seda-tion and received intravenous anesthesia with propofol and remifentanil. Operation time (T1),dosage of propofol and remifentanil,total waking time(T2),postoperative pain of 0.5 h(T3),4 h(T4),24 h(T5)by postoperative visual analogue scale(VAS),incidence of sore throat,lidocaine adverse reactions were recorded. Results Age, weight,T1,T2 and dosage of propofol between two groups had no statistical significance (P > 0.05). Dosage of remifentanil of group L was obviously less than that in group S (P < 0.05). VAS score T3 ,T4 of group L was obviously less than those in group S(P < 0.05). No significant difference was found on T5. Sore throat incidence of group L was lower than that in group S(P < 0.05). Lidocaine adverse reactions were not found in L group. Conclusions Intravenous lidocaine in hysteroscopy surgery is safe and effective under Narcotrend monitoring.
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Objective To investigate the effects of different depths of anesthesia on incidence of postopera-tive cognitive dysfunction (POCD). Methods We systematically retrievedPubmed,OVID,CNKI,CBM and Wanfang database and VIP database for randomized controlled trials(RCTs)from inceptionto December 312016, comparing different depths of anesthesia for their impacts on incidence of early POCD. After data extraction and quality evaluation,Revman 5.3 software was used for statistical data analysis. Results A total of 714 patients in 8 eligible RCTs were identified. Results of meta-analysis were as follows.(1)Incidence of POCD of depth anesthesia (NTS=E0-E1)was lower than general anesthesia(NTS=D0-D1)1 d after surgery(OR=0.21,95%CI 0.13~0.35,P < 0.00001).(2)Incidence of POCD of depth anesthesia(NTS = E1)was lower than general anesthesia (NTS=D0)7 d after surgery(OR=0.45,95%CI 0.23~0.91,P=0.03).(3)Incidence of POCD of NTS=E1 was lower than NTS=D07d after surgery(OR=0.42,95%CI 0.24~0.71,P=0.001). Conclusion Comparedwith general anesthesia,depth anesthesia is associated with a lower incidence of early POCD.
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Objective To observe intravenous lidocaine in patients undergoing hysteroscopy surgery under Narcotrend monitoring. Methods 80 patients undergoing elective hysteroscopy surgery were randomly divided into normal saline group(group S)and lidocaine group(group L). Before anesthesia induction ,group L was given lido-caine injection of 1.5 mg/kg,then with 2 mg/(kg·h)for infusion to the end of surgery. Group S received normal sa-line instead of lidocaine as the control. All patients received Narcotrend(NT)monitoring anesthesia depth of seda-tion and received intravenous anesthesia with propofol and remifentanil. Operation time (T1),dosage of propofol and remifentanil,total waking time(T2),postoperative pain of 0.5 h(T3),4 h(T4),24 h(T5)by postoperative visual analogue scale(VAS),incidence of sore throat,lidocaine adverse reactions were recorded. Results Age, weight,T1,T2 and dosage of propofol between two groups had no statistical significance (P > 0.05). Dosage of remifentanil of group L was obviously less than that in group S (P < 0.05). VAS score T3 ,T4 of group L was obviously less than those in group S(P < 0.05). No significant difference was found on T5. Sore throat incidence of group L was lower than that in group S(P < 0.05). Lidocaine adverse reactions were not found in L group. Conclusions Intravenous lidocaine in hysteroscopy surgery is safe and effective under Narcotrend monitoring.
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Objective:To investigate the effect of different depth of anesthesia monitoring in elderly cancer patients in the early postoperative cognitive dysfunction (POCD).Methods: 124 cases were received general anesthesia laparoscopic resection of colorectal cancer in elderly patients, and randomly divided into the observation group and the control group, each with 62 cases. The mean artery pressure (MAP) and heart rate of two groups of patients at different depth of anesthesia in each period were compared with the previous induction of anesthesia (t0), the organ before intubation (t1) and after intubation (t2), before pneumoperitoneum (t3) and after pneumoperitoneum (t4), after surgery (t5) and extubation (t6). The corresponding indexes were also compared between the two groups of patients. Results:In the control group, heart rate of t2, and t4~t6 increased significantly faster. The differences were statistically significant compared with the observation group (t=4.132,t=4.345,t=4.253,t=5.326;P<0.05). MAP parameters in the control group were significantly higher than that in the observation group and the differences were statistically significant (t=5.433, t=4.985,t=5.032,t=5.163;P<0.05). POCD in the observation group was significantly lower than that in the control group and the differences were statistically significant (x2=5.323,P<0.05).Conclusion: In elderly patients with laparoscopic colorectal surgery radical NTS will remain at D2 level, which can effectively reduce the incidence of POCD patients and help patients maintain stable hemodynamics. It is worth of further promoting in clinical.
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Objective To observe the action of narcotrend monitoring for perioperative anesthesia management in donor and acceptor with living donor renal transplantation. Methods 80 pairs of receptor and donor haing electie living donor renal transplantation surgery, 28 ~ 56 years. The ASA of receptor Ⅲ ~ Ⅳ, and the donerⅠ ~ Ⅱ. The receptor and donor were randomly divided into four groups , the narcotrend monitoring receptor group (R-N), the clinical experience receptor group (R-C), the narcotrend monitoring donor group (D-N), and the clinical experience donor group (D-C). Record the vital signs, the last time of anesthesia induction, operation , extract the endotracheal catheter , and the observation time in post anesthesia care unit , the dosage of propofol and dopamine, the adverse reaction, and postoperative visual analogue scale. Results The dosage of propofol in R-N group is less then the R-C group (P < 0.05). The time of extract the endotracheal catheter,and the observation time in post anesthesia care unit in R-N group was shorter then the R-C group (P < 0.05). No statistical differences between the D-N group and D-C group. Conclusions Narcotrend monitoring can significantly reduce the dosage of propofol , the observation time in post anesthesia care unit , and the postoperative adverse reactions. But there is little effect to the donor.
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OBJECTIVE:To explore the effect of propofol target-controlled infusion on extubation time in patients with ENT surgery under Narcotrend classification guidance. METHODS:52 patients with endotracheal intubation intravenous anesthesia and minimally invasive ENT surgery received target-controlled infusion for anesthesia induction and anesthesia. NI value, plasma concentration of propofol(cm),mean arterial pressure(MAP),pulse oxygen saturation(SpO2)before anesthesia and different time points in recovery period,the correlation of NI with propofol cm of all patients were recorded,and NI with propofol cm and time when extubation was omalysed. RESULTS:There were no significant differences in SpO2 before anesthesia and different time points in recovery period(P>0.05);MAP was significantly higher than before anesthesia at T3,MAP was significantly lower than before anesthesia at T0-T1,propofol cm was T0>T1>T2>T3>T4>T5,NI was significantly lower than before anesthesia at T0-T3, and T00.05). NI when extubation was(86.17±5.29),propofol cm was(0.96±0.31)μg/ml,and average extubation time was (8.26 ± 2.93) min. When extubation,NI showed negative correlation with propofol cm(r=-0.812);and decreased with the prolong of extubation time (r=-0.792);the predictive rates of NI and propofol cm's prediction awareness change in recovery period were 0.93 and 0.86. There were no obvious adverse reactions during treatment. CONCLUSIONS:Propofol target-controlled infusion under Narcotrend classification guidance can accurately predict the awareness change from no response to stimuli to shouting and opening eyes,has a high reference value on extubation time.
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Objective To compare the accuracy of bispectral index (BIS),Narcotrend index (NI),index of consciousness (IoC) versus auditory evoked potential index (AAI) in monitoring the depth of sedation induced by propofol.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 41-64 yr,with body mass index 20-30 kg/m2,scheduled for elective surgeries under general anesthesia,were enrolled in the study.Propofol was given by target-controlled infusion (TCI) with the initial target effect-site concentration (Ce) of 0.8 μg/ml using Marsh pharmacokinetic model,and then the Ce of propofol was increased by 0.1 μg/ml,and OAA/S was performed.Before TCI of propofol,the values of BIS,NI,IoC and AAI were recorded,and at the same time the value of OAA/S score was 5.During TCI of propofol,when OAA/S score reached 4,3,2 and 1 in turn,the Ce of propofol was recorded,the sequence for determination of the values of BIS,NI,IoC and AAI was determined using a random number table,and the values were then recorded for 5 s after the values were stable and then averaged.The parameters for vital signs were maintained within the normal range.Pearson correlation of BIS,NI,IoC and AAI values with Ce of propofol was analyzed.Results The correlation coefficients of BIS,NI,IoC and AAI values with the Ce of propofol were rBIs-Ce =-0.829,rSI-Ce =-0.886,rloC-Ce =-0.881 and rAAI-Ce =-0.791,respectively.There was no significant difference between rBIS-Ce,rNI-Ce,rIoC-Ce and rAAI-Ce.Conclusion There are no significant differences in the accuracy of BIS,NI,IoC or AAI in monitoring the depth of sedation induced by propofol in middle-aged patients with non-noxious stimuli.
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Objective To explore the value of Nacotrend and the degree and prognosis of disturbance of consciousness in craniocerebral injured patients. Methods Forty craniocerebral injured patients were observed and Nacotrend index (NI) and Glasgow Coma Scale (GCS) were evaluated 24 h after the operation. After followed up for 3 months, the patients with Glasgow coma scale (GOS) 4-5 scores were enrolled into in good recovery group and the patients with GOS 1-3 scores were enrolled into bad recovery group. The correlation of NI and prognosis was analyzed. Results There were 17 cases in the good recovery group, and 23 cases in the bad recovery group. Pearson correlation coefficient of NI and GCS was 0.721, P<0.01. The level of NI in good recovery group was 64.26±12.73, in bad recovery group was 29.57±8.12, and there was significant difference (P<0.05). Conclusion NI can be used in coma patients for consciousness grading assessment and also can correctly evaluate the prognosis.
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Objective To investigate the effect of different doses of sufentanil combined with dexmedetomidine ( DEX) on hemodynamic and Narcotrend index ( NI) during pediatric anesthesia induction. Methods A total of 45 children with lower abdominal surgery were randomly divided into three groups evenly: sufentanil 0. 1 μg·kg-1+ DEX (S1 group),sufentanil 0. 2 μg·kg-1+DEX (S2 group),and sufentanil 0. 3μg·kg-1+DEX (S3 group). Patients in each group began with intubation at the peak point of administration. Blood pressure,heart rate,perfusion index (PI) and NI were detected at the baseline (t0), delivering DEX 0.5 μg·kg-1·h-1 and sufentanil intravenously for 5 min (t1),delivering sufentanil for 3 min (t2),time of intubation ( t3 ) ,1 min ( t4 ) ,and 5 min ( t5 ) after intubation. The application rate of atropine and propofol was recorded. Patient recovery time and adverse reactions were observed. Results Compared with basicline value at t0 time point, hemodynamic parameters and NI were decreased at t1 and t2 ,while PI was increased in both groups. At t3 ,t4 ,and t5 ,all of the indicators in S1 group were significantly different from those at t0 ,and also significantly different from those in S2 and S3 group. Six patients were treated with propofol in S1 group and four presented with agitation after operation,more than S2 and S3 groups. Three patients were treatment with atropine in S3 group. Conclusion Sufentanil (0. 2 μg·kg-1 ) combined with dexmedetomidine can be used to induce intubation for pediatric anesthesia with stable hemodynamic profile and low incidence of adverse effects.
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Objective To investigate the feasibility of Narcotrend-guided application of small dose of dexmedetomidine ( DEX) for sedation during combined spinal-epidural anesthesia for elderly patients. Methods Fifty cases of ASA II or Ⅲelderly patients were randomly divided into treatment group and control group (25 patients of each group). After combined spinal-epidural anesthesia, both groups received continuous intravenous infusion of DEX, at 0. 4 μg·kg-1 in 10 min, and then the rate was lowered to 0. 4 μg·kg-1 per hour. For the treatment group, infusion rate was adjusted to reach a Narcotrend Index (NTI) of 75-85, and for the control group, infusion rate was adjusted to reach an OAA/S score of level 3-4. MAP, HR, RR, SpO2 , NTI and OAA/S score were recorded at the beginning of DEX treatment ( t0 ) , 10 min ( t1 ) , 20 min ( t2 ) , 30 min ( t3 ) , and 60 min ( t4 ) after the beginning of DEX treatment, and at the end of surgery ( t5 ) . The incidence rates of adverse events including bradycardia, hypotension, low oxygenation, and respiratory depression were also recorded. The patients were followed up until 24 h after surgery to record loss of memory about the surgical events. Results In comparison with t0 , NTI and MAP of both groups significantly decreased at t1-t5(P0. 05). Follow-up at 24 h after surgery observed total amnesia in 72. 0% of DEX group patients and in 76. 0% of the control group, without significant difference (P>0. 05). Conclusion Sedating elderly patients undergoing spinal-epidural anesthesia with DEX under the guidance of Narcotrend is safe and feasible, and the patients can be sedated properly.
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Objective To compare the effects of five different target-controlled concentrations of propofol combined with finite concentration of remifentanil on intraoperative awareness,so as to determine the safer and more effective concentration of propofol which could decrease explicit memory and reduce the incidence of intraoperative awareness. Methods One hundred and fifty patients ( ASAⅠ-Ⅱ) were randomly divided into five groups. There was no significant difference between each group in general condition. Before awaking,the target controlled concentration of remifentanil was adjusted to 2. 4 μg·L-1 in all five groups. Groups R1,R2,R3,R4 and R5 also received 0. 9%normal saline,0. 5 mg·L-1,1. 0 mg·L-1,1. 5 mg·L-1 and 2. 0 mg·L-1 of target controlled infusion ( TCI) of propofol, respectively. Narcotrend index ( NI), mean arterial pressure (MAP),heart rate (HR) and t [the time from t1(the time of awareness beginning) to the end of awareness] at t0(the time of adjusting propofol),t1,t2(the period of awareness),t3(wake period end 5 min) were recorded. Elimination of explicit memory after surgery was followed up. Results There were no significant differences in t and NI between groups R1,R2 and R3(P>0. 05). NI of groups R4 and R5 was significantly lower than that in groups R1,R2 and R3(P0. 05). Conclusion Target controlled infusion of remifentanil 2. 4μg·L-1 combined with TCI propofol 1. 0 mg·L-1 does not affect the wakening controllability. The circulation was steadier and explicit memory could be eliminated during intraoperative awakening.
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Objective To explore the correlation of patient-controlled sedation of dexmedetomidine and Narcotrend values. Methods Forty patients with lower limb surgery were enrolled. Until CSEA block fixed , the electronic pump ran the patient-controlled sedation of dexmedetomidine. The parameter of electronic pump was set as follows: load dose 2 mL + background dose 1.5 mL/h + single dose 0.5 mL + locktime 20 s. The heart rate , mean arterial pressure, pressing times, effective times, OAA/S sedation scores and NI values were determined. Results At T4 point, the patients reached appropriate sedation. At T4 ~ T9 OAA/S scores kept 3 to 4. From T5 point, NI values showed significant decrease. After the T7 point. OAA/S scores and NI values reached the plateau time of (7.5 ± 1.8) min and (13.1 ± 3.4) min, OAA/S scores of 1, 2, 3, 4, respectively, corresponding roughly with NI values 95 to 100, 90 to 94, 65 to 89, 40 to 64. The correlation coefficient was 0.58. The time of NI values significant decreased in the younger group and in the elderly group, with (10.2 ± 1.6) min and (14.4 ± 2.2) min. In T5~ T9 point, NI values of the younger group were significantly lower than those in the elderly group. Conclusion Relevant relationships are observed between dexmedetomidine patient-controlled sedation depth and the narcotrend values under CSEA.
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Objective To investigate the sedative effects and the adverse reactions in the elderly patients received different speed of dexmedetomidine (Dex) intravenous infusion. Methods Eighty elderly cases were randomly divided into four groups. Group D0 was the control group, while the group D1, D2 and D3 were the trial groups. The heart rates, blood pressure, SpO2, Ramsay sedation score and Narcotrend value were recorded. Results The sedation onset time of the D2, D3 group was faster than those in the D0 and D1 groups (P 0.05). Conclusion Intravenous infusion of Dex by doses of 0.75 ~ 1.0 μg/(kg·h) during hip surgery in the elderly patients under spinal anesthesia could lead to a safe and effective sedation.
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Objective To investigate the reliability of Narcotrend for monitoring the depth of sedation [the observer's assessment of alterness/sedation(OAA/S) scale] with midazolam and correlation between the depth of sedation and Narcotrend index.Methods 0 ASA Ⅰ-Ⅱ status patients scheduled for elective lower limb operations underwent spinal anesthesia,who were given target-controlled infusion of midazolam.Target plasma concentration was 50ng/ ml at first and increased by 10 ng/ml each grade until OAA/S scale became 1 point.Each target concentration infusion was maintained for 5min.Observe the patient the OAA/S scale to be 5 points.If the operation was not over yet,regulated the appropriate depth of sedation until the end of operation.The Narcotrend index of different OAA/S scale and heart rate,mean arterial pressure,respiration were recorded.Results In the deepening or recovery phase of sedation,OAA/S scales were correlated with Narcotrend index (Spearman' s r =0.786,0.652,all P ＜ 0.05).Conclusion Narcotrend is a good index to guide target controlled infusion of midazolam,the index is closely related with the depth of sedation of midazolam.
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Objective To evaluate the advantages and disadvantages of Narcotrend(NT)in monitoring the depth of anesthesia when compared with the bispectral index.Methods Eighty ASA Ⅰ or Ⅱ patients of both sexes,aged 19-60 yr,undergoing elective surgery,were enrolled in this clinical study.Propofol was given by target-controlled infusion(TCI).After the initial target plasma concentration of 2.1 μg/ml was achieved,the concentration was increased by 0.3 μg/ml every 30 s until the patients lost consciousness.Then the effect-site concentralion of propofol was increased by 0.5μg/ml to maintain anesthesia and rocuronium 0.8 mg /kg was injected intravenously 30 s later.Tracheal intubation was performed 3 min after rocuronium injection.Mean arterial pressure (MAP),HR,NT value and BIS value were measured before TCI of propofol(baseline),al loss of consciousness,immediately before rocuronium administration,2 min after rocuronium administration,during intubation,and at 1 and 3 min after intubation.Results NT and BIS values were significantly decreased at loss of consciousness as compared with the baseline value(P ＜ 0.01).NT and BIS values were significantly lower at 2 min after rcuronium administration than before rocuronium administration(P ＜ 0.05).Compared with that before intubalion,HR and MAP were significantly increased during intuhation,and at 1 and 3 min after intubation,while no significant change was found in NT and BIS values(P ＞ 0.05).Conctusion NT can monitor the sedative effecl induced with TCI of propofol accuralely,the myoelectric activity exerts an obvious effect,and the accuracy of NT for monitoring the analgesic effect is lower.NT and BIS are comparable with respect to the advantages and disadvantages.
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Objective To evaluate the predictive effects of Narcotrend(NT) monitor on laryngeal mask intubation and consciousness recovery in propofol-laryngeal mask total intravenous anesthesia of gynecilogical surgery.Methods Thirty ASA I patients undergoing elective gynecilogical surgery under general anesthesia with laryngeal mask intubation were anesthetized with propofol by target-controlled infusion (TCI).NT monitor was used to monitor the anesthesia depth.The ventilation was used on the closed circuit breathing mode of ZEUS anesthesia machine.The values of NT stage (NTS),NT index (NTI),the effect compartment concentration (Ce) and hemodynamic parameters were recorded during the time of sleeping,laryngeal mask intubation,propofol stopping pumping,recovery of spontaneous respiration and eyes opening.The incidence rate of intraoperative awareness was recorded.Results The NTI (77±23,30±9) (Z =5.561,P =0.001),Ce [(1.1±0.4) μg/ml vs (2.2±0.4) μg/ml] (Z=6.38,P=0.006),MAP [(92±14) mm Hg (1 mm Hg =0.133 kPa)vs (83±14) mm Hg] (t =2.490,P =0.016) and HR [(74±15) bpm vs (65±10) bpm] (t =2.688,P =0.009) of the time of intubation were significantly decreased compared to the time of sleeping.The NTI (37±7 vs 71±14)of the time of recovery of spontaneous respiration was significantly increased compared to the time of propofol stopping pumping (Z =6.34,P =0.005).The NTI (37±7 vs 83±13) (Z =6.668,P =0.003),Ce [(3.1±0.4) μg/ml vs (1.6±0.2) μg/ml] (Z =6.414,P =0.002) and HR[(59±7) bpm vs (64±8) bpm] (t =-2.825,P =0.006) of the time of eyes opening were statistically significant compared to the time of propofol stopping pumping.None of patients experienced intraoperative awareness.Conclusion NT monitor can effectively guide the intubation and extubation of laryngeal mask in total intravenous anesthesia of gynecilogical surgery.
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ObjectiveTo observe the changes of HR,MAP,BIS and Narcotrend induced by different doses of propofol in elderly patients. MethodsOne hundred elder patients(60 ～ 85 years old), AS A class Ⅰ or Ⅱ, scheduled for selective surgeries,were divided equally into 5 different doses of propofol( constant intravenous injection for 1min) groups of 0.5mg/kg( Ⅰ ) ,0. 75mg/kg( Ⅱ ) ,1.0mg/kg(Ⅲ) ,1.25mg/kg( Ⅳ)and 1.5mg/kg(Ⅴ). HR,MAP,BIS and Narcotrend were monitored before propofol injection and at 1 and 5 min after propofol injection. ResultsHR of 5 group s as similar. At 1 min after pmpofol injection, MAP decreased remarkably compared with at before in all 5 groups( t =2. 17,2.84,2.49,5.63,7.10, all p ＜ 0.05 ), which in group Ⅳ and Ⅴ decreased significantly compared with at in group Ⅰ, Ⅱ and Ⅲ(t =4.67,2.77,2.45,5.49,4.57,2. 18,all P＜0.05).At 1 min after propofol injection,BIS and NI values decreased compared with at before in all 5 groups(t =7.74,11.74,28.18,30.34,45.28, 6. 65,10.52,17.27,26.28,30. 14,allP ＜0.05) ,which in groupⅢ, Ⅳ and Ⅴ were significantly lower than those in group Ⅰ and Ⅱ (t =12.59,11.08,16.72,15.12,17.67,15.64,allP＜0.05).Dose of propofol was negatively correlated with BIS and NI value ( r =-0. 898/0. 930, P ＜ 0.01 ). ConclusionPropofol 1.0mg/kg constant injection should meet the sedation and hypnosis demand of general anesthesia in elderly patients and could not inhibit circulatory system; Bispectral Index and Narcotrend could accuratly monitor depth of anesthesia in elderly patients.