Narcotrend脑电监测全身麻醉对老年患者早期术后认知功能障碍的影响

发布时间：2018-04-23 01:20

本文选题：Narcotrend监测 + 全身麻醉　；参考：《中国老年学杂志》2015年10期

【摘要】：目的探讨Narcotrend脑电监测对全身麻醉老年患者术后认知功能障碍(POCD)的影响。方法选择该院收治的择期全麻行腹部手术的老年患者50例,随机分为观察组和对照组各25例,对照组麻醉医师根据临床经验判断麻醉深度并调整用药,观察组以NT监测数据判断麻醉深度并调整用药。常规监测患者心率(HR)、心电图(ECG)、平均动脉压(MAP)变化情况,计算麻醉期间丙泊酚用量、手术时间、拔管时间、清醒时间及认知功能障碍发生情况。结果两组患者诱导时MAP均有所下降,其他各时点两组HR、MAP检测值差异无统计学意义(P0.05);观察组丙泊酚用量显著低于对照组(P0.05);两组手术时间差异无统计学意义(P0.05),但观察组拔管时间及清醒时间显著早于对照组(P0.05);两组术前及术后24 h的简易智力状态检查法(MMSE)评分差异无统计学意义(P0.05);但观察组术中评分显著高于对照组(P0.05)。结论麻醉过程中采用Narcotrend脑电监测,可显著提高麻醉镇静深度判断的准确性,有效降低老年患者POCD的发生。
[Abstract]:Objective to investigate the effect of Narcotrend EEG monitoring on cognitive dysfunction after general anesthesia in elderly patients. Methods 50 elderly patients undergoing abdominal surgery under elective general anesthesia were randomly divided into two groups: the observation group (n = 25) and the control group (n = 25). The anesthesiologist in the control group judged the depth of anesthesia and adjusted the medication according to the clinical experience. The observation group used NT monitoring data to judge the depth of anesthesia and adjust the medication. The changes of HR, ECG and MAPP were monitored routinely. The dosage of propofol, the time of operation, the time of extubation, the time of waking up and the occurrence of cognitive dysfunction were calculated. Results the MAP decreased in both groups during induction. There was no significant difference in HRP map between the two groups at other time points, the dosage of propofol in the observation group was significantly lower than that in the control group (P 0.05), and there was no significant difference in the operation time between the two groups (P 0.05), but the extubation time and the waking time in the observation group were significantly earlier than those in the control group. There was no significant difference in MMSE score between the two groups before operation and 24 hours after operation, but the intraoperative score in the observation group was significantly higher than that in the control group (P 0.05). Conclusion Narcotrend EEG monitoring during anesthesia can significantly improve the accuracy of sedation depth judgment and reduce the incidence of POCD in elderly patients.
【作者单位】：六安市人民医院麻醉科;
【分类号】：R614.2

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