BIS监测应用于七氟醚吸入全身麻醉对老年腹腔镜胆囊切除术患者苏醒质量、应激反应和认知功能的影响  

Effects of BIS Monitoring on Awakening Quality, Stress Response and Cognitive Function in Elderly Patients Undergoing Laparoscopic Cholecystectomy Under Sevoflurane Inhalation General Anesthesia

作　　者：李陆军[1] 张绍刚[1] 曹雪莲[1] 张传磊 周田田 孙振全[1] LI Lu-jun;ZHANG Shao-gang;CAO Xue-lian;ZHANG Chuan-lei;ZHOU Tian-tian;SUN Zhen-quana(Department of Anesthesiology,Nanjing Integrated Traditional Chinese and Westerm Medicine Hospital,Nanjing,Jiangsu,210014,China)

机构地区：[1]南京市中西医结合医院麻醉科,江苏南京210014

出　　处：《现代生物医学进展》2022年第17期3289-3293,共5页Progress in Modern Biomedicine

基　　金：江苏省科技基金项目(BL2014012)。

摘　　要：目的:观察脑电双频指数(BIS)监测应用于七氟醚吸入全身麻醉对老年腹腔镜胆囊切除术(LC)患者苏醒质量、应激反应和认知功能的影响。方法:选择2018年4月~2021年6月期间我院收治需全麻下行LC的老年患者60例。随机分成对照组和BIS组,每组30例。对照组患者由同一位麻醉医师根据其临床经验调整麻醉深度。BIS组患者根据BIS值调整麻醉深度,BIS维持40~60。观察两组苏醒质量、血流动力学、应激反应和术后认知功能,记录不良反应发生情况。结果:BIS组的苏醒时间、呼吸恢复时间、拔管时间短于对照组(P<0.05)。插入喉罩后1 min(T1)~拔除喉罩后1 min(T3)时间点,BIS组的皮质醇(COR)、血糖低于对照组(P<0.05)。T0~T3时间点,BIS组的平均动脉压(MAP)和心率(HR)低于对照组(P<0.05)。BIS组术后1 d、术后3 d简易精神状态评价量表(MMSE)评分高于对照组(P<0.05)。两组不良反应发生率对比无统计学差异(P>0.05)。结论:BIS监测应用于七氟醚吸入全身麻醉的老年LC患者,可稳定血流动力学,减轻应激反应,提高患者苏醒质量,减轻认知功能损害。Objective: To observe the effect of bispectral index(BIS) monitoring on awakening quality, stress response and cognitive function in elderly patients undergoing laparoscopic cholecystectomy(LC) under sevoflurane inhalation general anesthesia.Methods: 60 elderly patients with LC under general anesthesia were selected from April 2018 to June 2021 in our hospital. They were randomly divided into control group and BIS group, with 30 cases in each group. The patients in the control group, the anesthesia depth was adjusted by the same anesthesiologist according to their clinical experience. The patients in the BIS group, anesthesia depth was adjusted according to BIS value, and BIS was maintained at 40 ~60. The quality of recovery, hemodynamics, stress response and postoperative cognitive function in the two groups were observed, and the incidence of adverse reactions was recorded. Results: The recovery time, respiratory recovery time and extubation time of BIS group were shorter than those of control group(P<0.05). Cortisol(COR) and blood glucose of BIS group were lower than those of control group at 1min after laryngeal mask insertion(T1) to 1min after laryngeal mask removal(T3)(P<0.05). mean arterial pressure(MAP) and heart rate(HR) of BIS group were lower than those of control group at T1~T3 time point(P<0.05). The mini-mental state examination scale(MMSE) scores of BIS group were higher than those of control group at 1d and 3d after operation(P<0.05). There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: BIS monitoring for elderly patients with LC under sevoflurane inhalation general anesthesia can stabilize hemodynamics, reduce stress response, improve the quality of patients’ recovery, and reduce cognitive impairment.

关 键 词：脑电双频指数 七氟醚吸入 全身麻醉 老年 腹腔镜胆囊切除术 苏醒质量 应激反应 认知功能 

分 类 号：R657.4[医药卫生—外科学]