Abstract:Objective To explore the application of entropy index monitoring for general anesthesia in the elderly patients underwent abdominal surgery.Methods A total of 60 elderly patients underwent elective abdominal surgery under general anesthesia who were admitted to our hospital from February 2018 to October 2019 were selected as the research objects,and they were divided into group E(n=30)and Group C(n=30)according to random number table method.Group E adjusted Remifentanil and Sevoflurane according to entropy index, group C adjusted Remifentanil and Sevoflurane according to blood pressure and heart rate (HR).The systolic blood pressure (SBP), diastolic blood pressure(DBP), HR at the time before anesthesia (T0), before induction (T1), after induction (T2), during skin incision (T3), after extubation (T4), the dosage of Remifentanil, the average inhalation concentration of Sevoflurane, the time of spontaneous breathing, eye opening, extubation, satisfaction scores , adverse reaction were compared between the two groups.Results The SBP, DBP and HR of group E at T1 were lower than those at T0, the differences were statistically significant(P<0.05).The SBP, DBP and HR in group C at T1 were lower than at T0, the SBP, DBP and HR in group C at T3 and T4 were higher than those at T0, the differences were statistically significant (P<0.05).The SBP, DBP and HR of group E at T1 were higher than those of group C, the SBP, DBP and HR of group E at T3 and T4 were lower than those of group C, the differences were statistically significant (P<0.05).There were no significant differences in SBP, DBP, HR between T2, T3, T4 and T0 in group E (P>0.05).There were no significant differences in SBP, DBP, HR between T0 and T2 in group C (P>0.05).There were no significant differences in SBP, DBP and HR between the two groups at T2 (P>0.05).The time of respiratory recovery, eye opening and extubation in Group E were shorter than those in group C, the dosage of anesthetics in Group E was less than that in group C, and the satisfaction rate in Group E was higher than that in group C, the differences were statistically significant (P<0.05).The incidence rates of nausea, hypotension, restlessness and cognitive impairment in Group E were lower than those in group C, the differences were statistically significant (P<0.05).There were no significant differences in the incidence of vomiting, intraoperative awareness, bradycardia and respiratory depression between the two groups (P>0.05).The total incidence of adverse reactions in Group E was lower than that in group C, the difference was statistically significant (P<0.05).Conclusion Application of entropy index monitoring in the elderly patients underwent abdominal surgery with general anesthesia can improve the anesthesia quality and save the anesthesia cost.
朱玉梅. 熵指数监测在老年全身麻醉下行腹部手术患者中的应用[J]. 中国当代医药, 2020, 27(13): 121-124.
ZHU Yu-mei. Application of entropy index monitoring for general anesthesia in the elderly patients underwent abdominal surgery. 中国当代医药, 2020, 27(13): 121-124.
Pappa M,Theodosiadis N,Tsounis A,et al.Pathogenesis and treatment of post-operative cognitive dysfunction[J].Electron Physician,2017,9(2):3768-3775.
[2]
Herter JM,Brenscheid N,Nienhaus L,et al.Analysis of cerebral glucose metabolism in patients with post-operative cognitive dysfunction[J].Minerva Anestesiol,2017,83(3):337-338.
[3]
Frank M,Nerlich K,Neuner B,et al.No convincing association between post-operative delirium and post-operative cognitive dysfunction:a secondary analysis[J].Acta Anaesthesiol Scand,2016,60(10):1404-1414.
[4]
Evered L,Silbert B,Scott DA.Pre-existing cognitive impairment and post-operative cognitive dysfunction:should we be talking the same language?[J].Int Psychogeriatr,2016,28(7):1053-1055.
Wang N,Ou Y,Qing W.Combined acupuncture and general anesthesia on immune and cognitive function in elderly patients following subtotal gastrectomy for gastric cancer[J].0ncol Lett,2018,15(1):189-194.
Ghaffary S,Ghaeli P,Talasaz AH,et al.Effect of memantine on post-operative cognitive dysfunction after cardiac surgeries:a randomized clinical trial[J].Daru,2017,25(1):24.
[10]
Sun SH,Yang L,Sun DF,et al.Effects of vasodilator and esmolol - induced hemodynamic stability on early postoperative cognitive dysfunction in elderly patients:a randomized trial[J].Afr Health Sci,2016,16(4):1056-1066.
[11]
Paredes S,Cortinez L,Contreras V,et al.Post-operative cognitive dysfunction at 3 months in adults after non-carciac surgery:a qualitative systematic review[J].Acta Anaesthesiol Scand,2016,60(8):1043-1058.