神经阻滞复合不同麻醉深度对老年下肢手术患者麻醉效果及认知功能的影响  

Effect of Nerve Block Combined with Different Depth of Anesthesia on Anesthetic Effect and Cognitive Function in Elderly Patients Undergoing Lower Extremity Surgery

作　　者：吴腾成 全守波 陈鸣岐 杨文长 邹启荣 WU Tengcheng;QUAN Shoubo;CHEN Mingqi;YANG Wenchang;ZOU Qirong(Department of Anesthesiology,Dongguan Songshanhu Central Hospital,Donguan,Guangdong 523000)

机构地区：[1]东莞市松山湖中心医院麻醉科,广东东莞523000

出　　处：《智慧健康》2023年第7期95-98,共4页Smart Healthcare

摘　　要：目的 将神经阻滞复合不同麻醉深度用于老年下肢手术患者中,探究其麻醉效果及认知功能的影响。方法 选取2018年1月-2022年5月收治的60例老年下肢手术患者,根据脑电双频指数值(BIS)进行分组,浅麻醉组(BIS值55~65)、深麻醉组各30例(BIS值40~50),两组均于麻醉诱导前行术侧神经阻滞,比较两组麻醉时间、芬太尼用量、丙泊酚用量、拔管及定向力恢复时间、MoCA评分、VAS评分差异。结果 两组麻醉时间、芬太尼用量相比,无显著差异(P>0.05),浅麻醉组丙泊酚用量较深麻醉组少,定向恢复力及拔管时间较深麻醉组短(P<0.05);两组术前、术后各时段MoCA评分相比,均无显著差异(P>0.05);两组术后1d、3d、7d的VAS评分相比,均无显著差异(P>0.05)。结论 对老年下肢手术患者而言,神经阻滞复合不同麻醉深度对其术后近期认知功能无显著影响,在神经阻滞完善情况下,浅麻醉利于缩短患者定向力恢复及拔管时间,还可减少麻醉药用量。Objective To explore the anesthetic effect and cognitive function of nerve block combined with different anesthesia depths in elderly patients undergoing lower extremity surgery.Methods 60 elderly patients with lower extremity surgery treated from January 2018 t to May 2022 were divided into two groups according to the bispectral index(BIS).There were 30 cases in the shallow anesthesia group(BIS 55-65)and 30 cases in t he deep anesthesia group(BIS 40-50).Both groups were subjected to lateral nerve block before anesthesia induction.The anesthesia time,fentanyl dosage,propofol dosage,extubation and directional recovery time,MOCA score and VAS score were compared between the two groups.Results There was no significant difference in anesthesia time and fentanyl dosage between the two groups(P>0.05).The dosage of propofol in the shallow anesthesia group was less than that in the deep anesthesia group,and the directional resilience and extubation time were shorter than that in the deep anesthesia group(P<0.05);There was no significant difference in MOCA scores between the two groups before and after operation(P>0.05);There was no significant difference in VAS scores between the two groups at 1d,3d and 7d after operation(P>0.05).Conclusion For elderly patients undergoing lower extremity surgery,nerve block combined with different anesthesia depths has no significant effect on their recent postoperative cognitive function.Under the condition of perfect nerve block,shallow anesthesia can shorten the recovery of orientation and extubation time of patients,and also reduce the dosage of anesthetics.

关 键 词：神经阻滞 不同麻醉深度 老年下肢手术 麻醉效果 认知功能 

分 类 号：R614[医药卫生—麻醉学]