脑电双频指数评估对老年腹腔镜手术麻醉患者平均动脉压、心率、pH、碱剩余、血糖的影响

发布时间：2018-05-03 21:12

本文选题：腹腔镜手术 + 麻醉深度　；参考：《中国老年学杂志》2017年16期

【摘要】：目的探讨脑电双频指数(BIS)评估对老年腹腔镜手术麻醉患者平均动脉压(MAP)、心率(HR)、pH、碱剩余(BE)、血糖(Glu)水平的影响。方法择期实施腹腔镜手术的高龄患者76例,通过数字标注法随机分组,其中观察组38例围术期结合BIS评估手术麻醉深度,实时控制调整麻醉用药;对照组38例仅依据麻醉医生经验与患者机体变化做麻醉用药控制,记录两组不同时间点MAP、HR、pH、BE、Glu水平变化,评估手术临床指标及术后恢复状态。结果观察组麻醉诱导后(T1)、术中30 min(T3)麻醉期间MAP水平明显低于麻醉前(T0);对照组T1、T3、术毕(T4)MAP水平与HR波动剧烈,呈明显下降趋势,与T0差异显著(P0.05);两组麻醉T3~拔管5 min(T6)Glu水平呈明显上升趋势,与同组T0差异显著(P0.05);观察组瑞芬太尼、异丙酚用药明显低于对照组(P0.05)。结论老年腹腔镜手术麻醉患者期辅助实施BIS评估可控制患者麻醉用药剂量,增强老年患者手术安全性,确保手术质量。
[Abstract]:Objective to investigate the effects of bispectral index (BIS) on the mean arterial pressure (MAPV), heart rate (HRN), pH of HRN, alkaline residual trochanter (BIS) and blood glucose (Glu) levels in elderly patients undergoing laparoscopic anesthesia. Methods Seventy-six elderly patients undergoing laparoscopic surgery were randomly divided into two groups: the observation group (n = 38) assessed the depth of anesthesia in perioperative period combined with BIS and adjusted the anesthetic medication in real time. In the control group, 38 patients were controlled with anesthesia only according to the experience of the anesthesiologist and the changes of the patient's body. The changes of MAPHR-pH Be-Glu were recorded at different time points in the two groups, and the clinical indexes of operation and postoperative recovery were evaluated. Results after anesthesia induction, the MAP level in the observation group was significantly lower than that in the control group during 30 minutes after anesthesia, while in the control group, the map level of T _ 4 and HR fluctuated sharply and decreased significantly. The level of T3 ~ extubation 5 min(T6)Glu in the two groups was significantly higher than that in the same group (P0.05), and the remifentanil and propofol in the observation group were significantly lower than that in the control group (P0.05). Conclusion BIS evaluation can control the dosage of anesthetic drugs, enhance the safety of operation and ensure the quality of operation in elderly patients undergoing laparoscopic anesthesia.
【作者单位】：首都医科大学附属北京朝阳医院麻醉科(西院);
【分类号】：R614

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