丙泊酚诱导速度对全麻下腹腔镜腹股沟疝修补术老年患者术后认知功能的影响  

Effect of propofol induction speed on postoperative cognitive function in elderly patients undergoing laparoscopic inguinal hernia repair under general anesthesia

作　　者：李婷婷 王胜 LI Tingting;WANG Sheng(Anesthesiology Department,Affiliated Provincial Hospital of Anhui Medical University,Hefei 230001,China)

机构地区：[1]安徽医科大学附属省立医院麻醉科,安徽合肥230001

出　　处：《临床医学研究与实践》2023年第13期67-70,共4页Clinical Research and Practice

摘　　要：目的探索丙泊酚诱导速度对全麻下腹腔镜腹股沟疝修补术老年患者术后认知功能的影响。方法选择2021年5月至11月于本院择期行全麻下腹腔镜腹股沟疝修补术的120例老年患者为研究对象,采用随机数字表法将其分为A组[丙泊酚诱导速度为100 mg/(kg·h)]和B组[丙泊酚诱导速度为300 mg/(kg·h)],各60例。两组中分别有1例患者因拒绝术后随访而未纳入到最后的统计学分析中。比较两组的麻醉相关指标。结果诱导期,B组的低血压发生率显著高于A组,使用去甲肾上腺素及麻黄碱的人次显著多于A组(P<0.05)。B组的丙泊酚诱导剂量显著高于A组(P<0.05);两组的手术时间、麻醉时间及术后第1天视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05)。两组麻醉诱导前(T_(0))、麻醉诱导后5 min(T_(1))、手术开始后5 min(T_(2))及手术结束后5 min(T_(3))的平均动脉压(MAP)及心率(HR)比较,差异无统计学意义(P>0.05)。术后1、7 d,B组的简易精神状态量表(MMSE)评分低于A组,术后认知功能障碍(POCD)发生率高于A组(P<0.05)。结论在行全麻下腹腔镜腹股沟疝修补术的老年患者的麻醉诱导中,使用丙泊酚慢速诱导[100 mg/(kg·h)]可降低低血压及POCD发生率,保证血压平稳,减少丙泊酚诱导剂量。Objective To explore the effect of propofol induction speed on postoperative cognitive function in elderly patients undergoing laparoscopic inguinal hernia repair under general anesthesia.Methods A total of 120 elderly patients who underwent elective laparoscopic inguinal hernia repair under general anesthesia in our hospital from May to November 2021 were selected as the research objects.The patients were divided into group A[propofol induction rate of 100 mg/(kg·h)]and group B[propofol induction rate of 300 mg/(kg·h)]by random number table method,with 60 cases in each group.One patient in each group was not included in the final statistical analysis due to refusal of postoperative follow-up.The anesthesia related indexes of the two groups were compared.Results During the induction period,the incidence of hypotension in the group B was significantly higher than that in the group A,and the numbers of people using norepinephrine and ephedrine were significantly more than those in the group A(P<0.05).The induction dose of propofol in the group B was significantly higher than that in the group A(P<0.05).There were no significant differences in operation time,anesthesia time and Visual Analogue Scale(VAS)score on the first day after operation between the two groups(P>0.05).There were no significant differences in mean arterial pressure(MAP)and heart rate(HR)between the two groups before anesthesia induction(T_(0)),at 5 min after anesthesia induction(T_(1)),at 5 min after the start of operation(T_(2))and at 5 min after operation(T_(3))(P>0.05).At 1 and 7 d after operation,the Mini-Mental State Examination(MMSE)score of the group B was lower than that of the group A,and the incidence of postoperative cognitive dysfunction(POCD)was higher than that of the group A(P<0.05).Conclusion Slow induction of propofol[100 mg/(kg·h)]in elderly patients undergoing laparoscopic inguinal hernia repair under general anesthesia can reduce the incidences of hypotension and POCD,ensure stable blood pressure,and reduce the induction do

关 键 词：丙泊酚 诱导速度 老年患者 术后认知功能 脑电双频指数 

分 类 号：R614[医药卫生—麻醉学]