意识指数监测在老年患者全凭静脉麻醉中的应用  

The Application of Consciousness Index Monitoring in Total Intravenous Anesthesia in Elderly Patients

作　　者：马晓玲 王一鸣 汤南南 李治松[1] MA Xiao-ling;Wang Yi-ming;Tang Nan-nan;Li Zhi-song(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院麻醉与围术期医学部,河南郑州450052

出　　处：《河南医学研究》2020年第30期5594-5597,共4页Henan Medical Research

摘　　要：目的探讨意识指数(IoC)监测在老年患者全身麻醉下腹腔镜肾部分切除术中的应用效果。方法选择2019年9—11月郑州大学第一附属医院择期于全身麻醉下接受腹腔镜下肾部分切除手术的患者58例,采用随机数表法将患者分为两组,BIS组接受脑电双频指数(BIS)监测麻醉深度,IoC组接受IoC监测麻醉深度。记录术中麻醉药物用量、术毕苏醒时间和拔管时间;统计术中循环波动和不良反应发生率;于术前1 d及术后1、3、7 d应用简易精神状态量表(MMSE)进行评分。结果IoC组术中丙泊酚、瑞芬太尼用量[(618.9±46.8)、(1.5±0.1)mg]少于BIS组[(673.8±38.8)、(1.6±0.1)mg],苏醒时间和拔管时间[(15.4±6.2)、(17.4±7.1)min]短于BIS组[(21.5±10.6)、(22.6±10.0)min],差异有统计学意义(P<0.05)。IoC组术中循环波动发生率[10.0%(3/30)]与BIS组[25%(7/28)]比较,差异无统计学意义(P>0.05);IoC组不良反应发生率为0,BIS组为3.6%(1/28),组间比较,差异无统计学意义(P>0.05)。IoC组术前及术后1、3、7 d的MMSE评分[(29.3±0.5)、(29.4±0.5)、(29.3±0.5)、(29.4±0.4)分]与BIS组[(29.3±0.4)、(29.1±0.5)、(29.3±0.5)、(29.3±0.5)分]比较,差异无统计学意义(P>0.05)。结论IoC监测可准确反映老年患者全身麻醉下行腹腔镜肾部分切除术的麻醉深度,且能明显减少麻醉药物用量,更好地维持术中血流动力学平稳,但对围手术期神经认知功能无明显影响。Objective To explore the effects of index of consciousness(IoC)monitoring on the dosage of anesthetics and perioperative neurocognitive disorders in laparoscopic partial nephrectomy under general anesthesia of elderly patients.Methods From September to November 2019,58 patients in the First Affiliated Hospital of Zhengzhou University who underwent laparoscopic partial nephrectomy under general anesthesia were selected.The patients were divided into two groups by random number table.The BIS group received EEG double frequency index(BIS)monitors the depth of anesthesia,and the IoC group received IoC to monitor the depth of anesthesia.The amount of anesthetics during the operation,the time to wake up after the operation,and the time of extubation were recorded.The incidence of intraoperative circulatory fluctuations and adverse reactions were calculated.The mini mental state scale(MMSE)was used to score 1 d before surgery and 1,3,7 d after surgery.Results Intraoperative propofol and remifentanil in the IoC group[(618.9±46.8),(1.5±0.1)mg]were less than those in the BIS group[(673.8±38.8),(1.6±0.1)mg],recovery time and the extubation time[(15.4±6.2),(17.4±7.1)min]were shorter those in the BIS group[(21.5±10.6),(22.6±10.0)min](P<0.05).There was no difference in the incidence of intraoperative circulatory fluctuation between IoC group[10.0%(3/30)]and BIS group[25%(7/28)](P>0.05);There was no difference in the incidence of adverse reactions between IoC group(0)and BIS group[3.6%(1/28)](P>0.05).There were no differences in the MMSE scores before surgery and 1,3,and 7 days after surgery between IoC group[(29.3±0.5),(29.4±0.5),(29.3±0.5),(29.4±0.4)points]and BIS group[(29.3±0.4)),(29.1±0.5),(29.3±0.5),(29.3±0.5)points](P>0.05).Conclusion IoC monitoring can accurately reflect the anesthesia depth of laparoscopic partial nephrectomy under general anesthesia of gerontal patients,and can significantly reduce the dosage of anesthetics,better maintain the hemodynamic stability during operation,but has no significa

关 键 词：麻醉深度监测 意识指数 认知功能 围手术期 

分 类 号：R614[医药卫生—麻醉学]