IOC1联合IOC2监测在持续植物状态和微小意识状态患者全身麻醉中的应用效果  

Application effect of IOC1 combined with IOC2 monitoring in patients with persistentvegetative state and minimally conscious state during general anesthesia

作　　者：李响 陈朝阳 程庆 王馨雪 张蓉[1] 赵泽宇 LI Xiang;CHEN Chaoyang;CHENG Qing;WANG Xinxue;ZHANG Rong;ZHAO Zeyu(Department of Anesthesiology,Sichuan Rehabilitation Hospital Affiliated to Chengdu University of Traditional Chinese Medicine/Sichuan Bayi Rehabilitation Center,Chengdu,Sichuan 611135,China)

机构地区：[1]成都中医药大学附属四川省康复医院/四川省八一康复中心麻醉科,四川成都611135

出　　处：《检验医学与临床》2025年第1期66-69,75,共5页Laboratory Medicine and Clinic

基　　金：四川省卫生健康委员会基金项目(19PJ255)。

摘　　要：目的 分析脑电意识指数(IOC1)联合伤害敏感指数(IOC2)监测在持续植物状态(PVS)和微小意识状态(MCS)患者全身麻醉中的应用效果。方法 选取2022年3月至2023年9月在该院进行手术的50例PVS或MCS患者作为研究对象,按照随机数字表法将其分为对照组和意识指数监测组,各25例。对照组进行常规监测,意识指数监测组同时监测IOC1和IOC2。记录两组麻醉前(T_(0))、诱导后(T_(1))、插管后(T_(2))、手术开始5 min (T_(3))、手术结束(T_(4))平均动脉压(MAP)和心率(HR)。记录两组麻醉期间各时间指标、瑞芬太尼和七氟醚用量及低血压和窦性心动过缓发生率。结果 对照组T_(1)、T_(2)、T_(3)、T_(4)的MAP低于T_(0),且T_(3)低于T_(1)、T_(2),T_(4)高于T_(3),差异均有统计学意义(P<0.05)。意识指数监测组T_(1)、T_(2)、T_(3)、T_(4)的MAP低于T_(0),且T_(3)、T_(4)的MAP高于T_(1)、T_(2),差异均有统计学意义(P<0.05)。对照组T_(1)、T_(2)、T_(3)、T_(4)的HR低于T_(0),且T_(3)低于T_(1)、T_(2),T_(4)高于T_(3),差异均有统计学意义(P<0.05)。意识指数监测组T_(1)、T_(2)、T_(3)、T_(4)的HR低于T_(0),且T_(4)的HR高于T_(1)、T_(2)、T_(3),差异均有统计学意义(P<0.05)。意识指数监测组拔管时间及麻醉恢复室滞留时间短于对照组,瑞芬太尼和七氟醚用量少于对照组,术中低血压发生率低于对照组,差异均有统计学意义(P<0.05)。结论 在PVS和MCS患者麻醉中,采用IOC1和IOC2监测可减少麻醉药物用量,稳定血压和HR,准确预判拔管时机并缩短麻醉恢复室滞留时间。Objective To analyze the application effect of consciousness index(IOC1)and nociceptive sensitivity index(IOC2)monitoring in patients with persistent vegetative state(PVS)the minimally conscious state(MCS)during general anesthesia.Methods Fifty patients with PVS or MCS who underwent surgery in this hospital from March 2022 to September 2023 were randomly divided into the control group and the consciousness index monitoring group,25 cases in each group.Routine monitoring was performed in the control group,and IOC1 and IOC2 were monitored in the consciousness index monitoring group at the same time.Mean arterial pressure(MAP)and heart rate(HR)of two groups were collected before anesthesia(T_(0)),after induction(T_(1)),after intubation(T_(2)),5 min after surgery(T_(3))and at the end of surgery(T_(4)).The time index,dosage of remifentanil and sevoflurane,incidence of hypotension and sinus bradycardia during anesthesia were recorded.Results The MAP of T_(1),T_(2),T_(3),T_(4) in the control group was lower than that of T_(0),and the MAP of T_(3) was lower than that of T_(1) and T_(2),and the MAP of T_(4) was higher than that of T_(3),and the differences were statistically significant(P<0.05).The MAP of T_(1),T_(2),T_(3) and T_(4) in the consciousness index monitoring group was lower than that of T_(0),and the MAP of T_(3) and T_(4) was higher than that of T_(1) and T_(2),and the differences were statistically significant(P<0.05).The HR of T_(1),T_(2),T_(3),T_(4) in the control group was lower than that of T_(0),and the HR of T_(3) was lower than that of T_(1) and T_(2),and the HR of T_(4) was higher than that of T_(3),and the differences were statistically significant(P<0.05).The HR of T_(1),T_(2),T_(3),T_(4) in the consciousness index monitoring group was lower than that of T_(0),and the HR of T_(4) was higher than that of T_(1),T_(2),T_(3),and the differences were statistically significant(P<0.05).The extubation time and anesthesia recovery room retention time in the consciousness index monitoring group were shorter

关 键 词：深度镇静 伤害性疼痛 危重症监护结局 全身麻醉 定量意识指数 

分 类 号：R614.2[医药卫生—麻醉学] R472.9[医药卫生—外科学]