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

摘要： 目的　研究妇科腹腔镜手术中Narcotrend指导下七氟醚联合丙泊酚麻醉的效果及对血液动力学、认知功能和七氟醚用量的影响。方法　选取2016年1月至2017年3月80例在我院择期行妇科腹腔镜手术患者为研究对象,将纳入患者按分为Narcotrend组与对照组,每组40例。所有患者均给予静吸复合麻醉,Narcotrend组在Narcotrend指导下进行麻醉,对照组凭借麻醉医师临床经验,根据患者生命体征,维持合适麻醉深度。记录患者入室（T0）、麻醉诱导后2min（T1）、气管插管即刻（T2）、建立气腹即刻（T3）、建立气腹后15min（T4）、拔除气管即刻（T5）心率与平均动脉压,比较两组七氟醚、丙泊酚用量及自主呼吸恢复时间,评估患者认知功能。结果　Narcotrend组T2、T3、T5心率、平均动脉压显著低于对照组（P<0.05）。Narcotrend组七氟醚用量、丙泊酚用量、自主呼吸恢复时间分别为10.82±1.95mL/h、82.72±14.90mg、9.31±1.68min显著低于对照组的13.15±2.36mL/h、94.02±16.92mg、10.65±1.92min（P<0.05）。Narcotrend组术后1d简易精神状态评分（MMSE）、蒙特利尔认知评估认知评分（MoCA）显著高于对照组（P<0.05）。结论　在Narcotrend指导下进行妇科腹腔镜手术,可以使麻醉更接近理想状态,减少麻醉药物用量，稳定血液动力学，减轻对认知功能的影响。

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