丙泊酚靶控输注麻醉与七氟烷吸入麻醉对机器人辅助腹腔镜下根治性前列腺切除术中患者脑氧代谢及认知功能的影响  

Effects of propofol target-controlled infusion anaesthesia and sevoflurane inhalation anaesthesia on cerebral oxygen metabolism and cognitive function in patients undergoing robot-assisted laparoscopic radical prostatectomy

作　　者：商燕 梁静 吕玉珠 王彬荣 柴伟 李艳 SHANG Yan;LIANG Jing;LYU Yuzhu;WANG Binrong;CHAI Wei;LI Yan(Department of Anesthesiology,Xi’an International Medical Center Hospital,Xi’an 710000,China)

机构地区：[1]西安国际医学中心医院麻醉科,陕西西安710000

出　　处：《机器人外科学杂志(中英文)》2025年第2期251-255,共5页Chinese Journal of Robotic Surgery

基　　金：陕西省重点研发计划项目(2022SF-487)。

摘　　要：目的:探讨丙泊酚靶控输注麻醉与七氟烷吸入麻醉对机器人辅助腹腔镜下根治性前列腺切除术中患者脑氧代谢及认知功能的影响。方法:选取2021年2月-2023年8月西安国际医学中心医院收治的122例行机器人辅助腹腔镜下根治性前列腺切除术患者作为研究对象,按照随机数表法将所有患者分为研究组(丙泊酚靶控输注麻醉,n=61)和对照组(七氟烷吸入麻醉,n=61)。比较两组患者恢复指标、脑氧饱和度、认知功能(MMSE评分)及不良反应发生情况。结果:相较于对照组,研究组呼吸恢复时间、睁眼时间、拔管时间、出室时间均更低(P<0.05)。相较于诱导前,两组吸氧时、诱导后5 min、术中、术毕脑氧饱和度均降低(P<0.05),但研究组术中、术毕、睁眼时脑氧饱和度高于对照组(P<0.05)。相较于诱导前,两组睁眼时、术后1 d MMSE评分均降低(P<0.05),但研究组睁眼时、术后1 d MMSE评分高于对照组(P<0.05)。比较两组不良反应发生率,差异无统计学意义(P>0.05)。结论:机器人辅助腹腔镜下根治性前列腺切除术中应用丙泊酚靶控输注麻醉可有效保持患者脑氧饱和度正常,促进术后恢复,减少其对认知功能的影响,且安全性较好。Objective:To Explore the effects of propofol target-controlled infusion anesthesia and sevoflurane inhalation anesthesia on cerebral oxygen metabolism and cognitive function in patients undergoing robot-assisted laparoscopic radical prostatectomy(RARP).Methods:122 patients who underwent RARP from February 2021 to August 2023 in Xi’an International Medical Center Hospital were selected and divided into the study group(n=61,propofol target-controlled infusion anesthesia)and the control group(n=61,sevoflurane inhalation anesthesia)using a random number table.The recovery indicators,cerebral oxygen saturation,cognitive function(MMSE score),and adverse reactions were compared between the two groups of patients.Results:The respiratory recovery time,eye-opening time,and extubation time were lower in the study group than those in the control group(P<0.05).Compared with that before induction,cerebral oxygen saturation was both decreased in the two groups during oxygenation,5 minutes after induction,during and after surgery(P<0.05),while the cerebral oxygen saturation in the study group was higher than that in the control group at the time of during and after surgery,and eye-opening(P<0.05).Compared with that before induction,MMSE scores at eye-opening and 1 day after surgery were both decreased in the two groups(P<0.05),but they were relatively higher in the study group(P<0.05).There was no statistically significant difference in the complication rates between the two groups(P<0.05).Conclusion:The application of propofol target-controlled infusion anesthesia in patients undergoing RARP radical prostatectomy can effectively and safely maintain normal cerebral oxygen saturation,promote postoperative recovery,reduce its impact on cognitive function.

关 键 词：根治性前列腺切除术 机器人辅助手术 丙泊酚靶控输注麻醉 七氟烷吸入麻醉 

分 类 号：R614[医药卫生—麻醉学]