关键词: 血液动力学, 妇科腹腔镜手术, Narcotrend 麻醉深度监测仪, 七氟醚, 丙泊酚, 认知 功能

Abstract: Objective To study the effects of Narcotrend guided sevoflurane combined with propofol anesthesia in patients undergoing gynecological laparoscopic operation and the influence on hemodynam-ics, cognitive function and dosage of sevoflurane. Methods Eighty patients who underwent elective gynecological laparoscopic operation in the hospital from January 2016 to March 2017 were selected as the subjects. The patients were assigned to Narcotrend group and control group, 40 cases in each group. All patients were given intravenous- inhalation combined anesthesia. Narcotrend group was given Narco-trend-guided anesthesia while the control group was given anesthesia according to the clinical experience of anesthesiologists. According to patient′s vital signs, the appropriate depth of anesthesia was maintained. The heart rate and mean arterial pressure of patients were recorded on entering（T0）, at 2 min after in-duction of anesthesia （T1）, at tracheal intubation （T2）, at the establishment of pneumoperitoneum （T3）, at 15 min after establishing pneumoperitoneum（T4）and at extubation（T5）. The dosage of sevoflurane and remifentanil and spontaneous breathing recovery time were compared between the two groups. The cognitive function was assessed. Results The heart rate and mean arterial pressure of Narcotrend group at T2, T3 and T5 were significantly lower than those of the control group（P<0.05）. The dosage of sevoflurane and propofol and spontaneous breathing recovery time in Narcotrend group（10.82±1.95 ml/h, 0.16±0.03 μg/kg · min, 9.31±1.68 min）were significantly less or shorter than those in the control group（13.15±2.36 ml/h, 0.20±0.04 μg/kg·min, 10.65±1.92 min）（all P values<0.05）. Scores of mini?mental state examination （MMSE） and Montreal cognitive assessment （MoCA） in Narcotrend group at 1 d after operation were significantly higher than those in the control group（P<0.05）. Conclusion The Narcotrend- guided gynecological laparoscopic operation can make anesthesia closer to the ideal state, reduce the dosage of anesthetics, stabilize hemodynamics and reduce the impact on cognitive function.

Key words: monitor, hemodynamics, sevoflurane, cognitive function, propofol