摘要
目的 分析不同麻醉方案经脑电双频指数(bispectral index,BIS)监测对认知功能的影响。方法 方便选择2022年1月—2023年1月兴化市人民医院收治的42例食管癌患者为研究对象,以抽签法按序分为研究组和对照组,各21例。两组患者均接受全麻下食管癌根治手术治疗,为研究组提供BIS监测下联合七氟烷复合术中静脉泵注瑞芬太尼及丙泊酚麻醉方案,对照组则接受BIS监测下丙泊酚复合瑞芬太尼术中静脉泵注麻醉方案。对比两组患者手术期间不同点的心率和平均动脉压变化、认知功能评分和围术期麻醉相关不良反应,以及术后认知功能障碍(postoperative cognitive dysfunction,POCD)发生率。结果 诱导前、插管后1 h和手术结束时,两组心率和平均动脉比较,差异无统计学意义(P>0.05);术后30 min和1~6 h,研究组的认知功能评分均明显高于对照组,差异有统计学意义(P<0.05)。研究组围术期麻醉总不良反应发生率为23.81%,低于对照组的38.10%,差异无统计学意义(χ^(2)=1.003,P=0.317)。对照组的术后不同时期的POCD总发生率为42.86%,明显高于研究组的14.29%,差异有统计学意义(χ^(2)=4.200,P<0.05)。结论 针对全麻下行食管癌根治手术治疗患者,术中采取BIS深度监测联合七氟烷复合术中静脉泵注瑞芬太尼及丙泊酚麻醉方案,可降低对认知功能的影响,提高麻醉安全性。
Objective To analyze the effects of different anesthesia protocols on cognitive function via bispectral index(BIS) monitoring.Methods A total of 42 patients with esophageal cancer treated in Xinghua People's Hospital from January 2022 to January 2023 were conveniently selected as the study objects and divided into study group and control group by drawing lots,with 21 cases in each group.Patients in both groups received radical surgery for esophageal cancer under general anesthesia.The study group was provided with BIS monitoring combined with sevoflurane and intraoperative intravenous pump infusion of remifentanil and propofol,while the control group was provided with BIS monitoring combined with remifentanil intraoperative intravenous pump infusion of anesthesia.The changes of heart rate and mean arterial pressure,cognitive function scores,perioperative anesthesia-related adverse reactions,and postoperative cognitive dysfunction(POCD) incidence were compared between the two groups at different points during surgery.Results Before induction,1 h after intubation and at the end of surgery,there was no statistically significant difference in heart rate and mean artery between the two groups(P<0.05).The cognitive function scores of the study group were significantly higher than those of the control group 30 min and 1-6 h after operation,and the difference was statistically significant(P>0.05).The incidence of perioperative adverse reactions in the study group was 23.81%,which was lower than that in the control group(38.10%),and the difference was statistically significant(χ^(2)=1.003,P=0.317).The total incidence of POCD in the control group was 42.86%,which was significantly higher than that in the study group(14.29%),and the difference was statistically significant(χ^(2)=4.200,P<0.05).Conclusion For patients undergoing radical surgical treatment for esophageal cancer under general anesthesia,BIS deep monitoring combined with sevoflurane combined with intravenous pump infusion of remifentanil and propofol during the operation can reduce the impact on cognitive function and improve the safety of anesthesia.
作者
袁竹青
包全堂
王丁木
YUAN Zhuqing;BAO Quantang;WANG Dingmu(Department of Anesthesiology,Xinghua People's Hospital,Xinghua,Jiangsu Province,225700 China)
出处
《中外医疗》
2023年第20期69-72,77,共5页
China & Foreign Medical Treatment
关键词
脑电双频指数
食管癌根治术
术后认知功能障碍
EEG bispectral index
Radical esophageal cancer surgery
Postoperative cognitive dysfunction
作者简介
袁竹青(1988-),女,本科,主治医师,研究方向为麻醉深度监测方面。
