Wilhelm W, Kreuer S, Larsen R
Klinik für Anaesthesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, Homburg/Saar.
Anaesthesist. 2002 Dec;51(12):980-8. doi: 10.1007/s00101-002-0417-3.
The Narcotrend is a new EEG monitor designed to measure the hypnotic component of anaesthesia; however, a major clinical evaluation is still missing. This prospective multicentre study was designed to investigate the feasibility of Narcotrend monitoring in a large number of patients under different clinical conditions and to define its impact on recovery times after propofol-based total intravenous anaesthesia.
After legal authority approval and patients'informed consent had been obtained, total intravenous anaesthesia was induced and maintained with propofol and an opioid analgesic at the discretion of the attending anaesthesiologist. In the first 10-15 patients of each centre the anaesthesiologist was blinded to the Narcotrend recordings and propofol was dosed according to clinical needs. In the following patients propofol was infused at a rate sufficient to achieve a target Narcotrend stage of D or E. With termination of propofol infusion,recovery times were recorded and analysed for the patients with or without Narcotrend monitoring; in addition, recovery times were analysed depending on the Narcotrend stage at the moment of termination of propofol infusion.
In total, 4,630 adult patients were studied at 46 institutions, 521 without and 4,109 with Narcotrend monitoring. Demographic data and duration of anaesthesia were comparable. Emergence from anaesthesia was significantly shorter in Narcotrend monitored patients, e.g.opening eyes after 9.8+/-5.9 (mean+/-SD) vs.11.8+/-7.1 min. In addition,awakening was significantly more rapid when the propofol infusion was stopped at a lower level of hypnosis as indicated by Narcotrend monitoring, e.g.opening eyes after 7.1+/-4.5 min with stage C instead of 17.0+/-7.4 min with stage F.
The EEG monitor Narcotrend can be used for adult patients of different ages and during various surgical procedures.Narcotrend monitoring facilitates a reduction of recovery times after propofol-based total intravenous anaesthesia,presumably by allowing for an individual titration of the propofol dosage. Moreover, it appears that the profile of recovery can be optimised when at the end of surgery,the propofol infusion is controlled to Narcotrend stage C instead of D, E, or F.
脑电意识深度监测系统（Narcotrend）是一款新型脑电图监测仪，旨在测量麻醉的催眠成分；然而，其主要临床评估仍有所欠缺。这项前瞻性多中心研究旨在调查在不同临床条件下，对大量患者进行Narcotrend监测的可行性，并确定其对丙泊酚全凭静脉麻醉后恢复时间的影响。
在获得法律授权批准和患者知情同意后，由主治麻醉医生酌情使用丙泊酚和阿片类镇痛药诱导并维持全凭静脉麻醉。在每个中心的前10 - 15例患者中，麻醉医生对Narcotrend记录结果不知情，丙泊酚根据临床需要给药。在随后的患者中，以足以达到D或E目标Narcotrend阶段的速率输注丙泊酚。随着丙泊酚输注的终止，记录并分析有无Narcotrend监测患者的恢复时间；此外，根据丙泊酚输注终止时的Narcotrend阶段分析恢复时间。
共有46家机构对4630例成年患者进行了研究，其中521例未进行Narcotrend监测，4109例进行了Narcotrend监测。人口统计学数据和麻醉持续时间具有可比性。Narcotrend监测的患者麻醉苏醒明显更短，例如睁眼时间为9.8±5.9（均值±标准差）分钟，而未监测者为11.8±7.1分钟。此外，如Narcotrend监测所示，当在较低催眠水平停止丙泊酚输注时，苏醒明显更快，例如在C阶段停止输注时睁眼时间为7.1±4.5分钟，而在F阶段则为17.0±7.4分钟。
脑电图监测仪Narcotrend可用于不同年龄阶段的成年患者以及各种外科手术过程中。Narcotrend监测有助于缩短丙泊酚全凭静脉麻醉后的恢复时间，这可能是通过允许对丙泊酚剂量进行个体化滴定实现的。此外，在手术结束时，将丙泊酚输注控制在Narcotrend阶段C而非D、E或F似乎可以优化恢复情况。
