Abstract：Objection To investigate the application effect of Narcotrend monitoring in tracheal extubation in elderly patients with hypertension during general anesthesia recovery time.Methods90 elderly hypertensive patients in our hospital from August 2015 to June 2016 undergoing elective operation in general anesthesia were selected.All patients were randomly divided into three groups(n=30)according to the NT value during recovery time.The NT value of recovery period∶group A was maintained was 55.0±5.0,group B was 75.0±5.0,group C was 95.0±5.0.Preoperative blood pressure was controlled below 160/100 mmHg in all patients,and NT monitoring was performed from the beginning of anesthesia to the recovery of patients.After the end of surgery continous infusion of propofol until extubation.The endotracheal tube was removed after full recovery of respiration and the propofol infusion was stopped immediately after extubation.Compared the changes of MAP and HR before and after extubation of three groups of patients,recovery time,observers assessment of alertness/sedation(OAA/S)scale,cough reaction,oropharygeal airway utilization and extubation awareness incidence.ResultsThere were no significant changes of MAP and HR in groups A and B before and after extubation(P＞0.05).After extubation,MAP and HR of group C increased significantly compared with before extubation(P＜0.05).MAP and HR in group C were significantly higher than those in group A and B after extubation(P＜0.05).Compared with group B and C,the oropharyngeal airway utilization and awake time of group A increased significantly,the difference was statistically significant(P＜0.05).The rate of cough and extubation awareness of group C were significantly higher than that of group A and B (P＜0.05).ConclusionThe NT value of 75.0±5.0 can be a proper indication of tracheal extubation under deep sedation in elder patients with hypertension.
Guler G，Akin A，Tosun Z，et al.Single-dose dexmedetomidine attenuates airway and circulatory reflexes during extubation[J].Acta Anaesthesiol Scand，2005，49（8）：1088-1091.
[11]
Aksu R，Akin A，Bicer C，et al.Comparison of the effects of dexmedetomidine versus fentanyl on airway reflexes and hemodynamic responses to tracheal extubation during rhinoplasty：a double-blind，randomized，controlled study[J]. Curr Ther Res Clin Exp，2009，70（3）：209-220.
Jiang Y，Qiao B，Wu L，et al.Application of Narcotrend® monitor for evaluation of depth of anesthesia in infants undergoing cardiac surgery：a prospective control study[J]. Bras J Anesthesiol，2013，63（3）：273-278.
[19]
Guo Z，Pang L，Jia X，et al.Intraoperative target-controlled infusion anesthesia application using remifentanil hydrochloride with etomidate in patients with severe burn as monitored using Narcotrend[J].Burns，2015，41（1）：100-105.
[20]
Wehrmann T.Extended monitoring of the sedated patient：bispectral index，narcotrend and automated responsiveness monitor[J].Digestion，2010，82（2）：90-93.
[21]
Rundshagen I，Hardt T，Cortina K，et al.Narcotrend-assisted propofol/remifentanil anaesthesia vs clinical practice：does it make a difference?[J].Br J Anaesth，2007，99（5）：686-693.
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