摘要
目的:探讨Narcotrend监测下不同麻醉深度对老年患者腹腔镜术后谵妄的影响。方法:选取2017年1月-2019年8月本院择期进行腹腔镜手术的老年患者90例,按随机数字表法分为A、B、C组,每组30例。三组Narcotrend监测下麻醉深度分别控制在D0-D1、D2-E0、E1水平。比较三组围手术期用药情况,不同时间点心率(HR)与平均动脉压(MAP)及术后24、48、72 h谵妄发生情况。结果:三组围手术期瑞芬太尼用量比较,差异无统计学意义(P>0.05);C组围手术期丙泊酚用量均高于A、B组,且B组围手术期丙泊酚用量高于A组(P<0.05)。三组麻醉诱导前、气管插管前、手术开始时、手术开始后1、2 h、手术结束时HR与MAP比较,差异均无统计学意义(P>0.05)。C组术后24、48、72 h谵总妄发生率均高于A、B组(P<0.05)。结论:Narcotrend监测下麻醉深度处于D0-D1、D2-E0水平可有效降低老年腹腔镜手术患者术后谵妄的发生率,值得临床上推广。
Objective:To explore the effect of different anesthesia depth under the Narcotrend monitoring on delirium after laparoscopic surgery in elderly patients.Method:A total of 90 elderly patients underwent laparoscopic surgery at selected time in our hospital from January 2017 to August 2019 were selected.They were divided into groups A,B and C according to the method of random number table,30 cases in each group.The anesthetic depth under the Narcotrend monitoring of the three groups was controlled at the levels of D0-D1,D2-E0,E1 respectively.Perioperative medication,heart rate(HR)and mean arterial pressure(MAP)at different time points,and delirium incidence at 24,48 and 72 h after surgery of the three groups were compared.Result:There was no significant difference in perioperative Remifentanil dosage among the three groups(P>0.05).The perioperative Propofol dosage in the group C were higher than those in the groups A and B,and the perioperative Propofol dosage in the group B was higher than that in the group A(P<0.05).There were no statistically significant differences in HR and MAP of the three groups before anesthesia induction,before endotracheal intubation,at the beginning of surgery,1 and 2 h after surgery and at the end of surgery(P>0.05).The total incidence of delirium in the group C were higher than those in the groups A and B at 24,48 and 72 h after surgery(P<0.05).Conclusion:The anesthesia depth under Narcotrend monitoring at D0-D1 D2-E0 levels can effectively reduce the incidence of postoperative delirium in elderly patients with laparoscopic surgery,which is worthy of clinical promotion.
作者
黎邝
潘俊佐
张晓霞
LI Kuang;PAN Junzuo;ZHANG Xiaoxia(Maoming Agricultural Reclamation Hospital,Maoming 525200,China)
出处
《中国医学创新》
CAS
2020年第9期49-52,共4页
Medical Innovation of China
基金
茂名市科技计划项目(2018259)。
作者简介
通信作者:黎邝。
