闭环靶控输注下不同麻醉深度对老年全身麻醉患者术中血流动力学及术后认知功能障碍的影响

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Abstract Objective To investigate the effects of different anesthesia depths under closed circle target-controlled infusion on intraoperative hemodynamics and postoperative cognitive dysfunction in elderly patients under general anesthesia. Methods Eighty elderly patients who underwent elective general anesthesia in Affiliated Hospital of Xuzhou Medical University from January 2018 to January 2021 were selected and divided into the observation group (40 cases)and the control group (40 cases) according to the random number table method. The control group was given general anesthesia with BIS 45 under closed target-controlled infusion. In the observation group, BIS was set at 55 under closed loop target controlled infusion for general anesthesia. Intraoperative hemodynamics at different times (Immediate after intubation [T1], 20 min [T2]after the start of surgery, 60 min [T3]after the start of surgery, 100 min after the start of surgery [T4], and immediate extraction of the tracheal catheter [T5]) and postoperative cognitive dysfunction at different times were compared between the two groups. Results The heart rate (HR) of the observation group at T2, T3, T4 was higher than that at T1 in the group, with statistically significant difference (P＜0.05). The mean arterial pressure (MAP)the observation group at T2, T3, T4, T5 was higher than that at T1 in the group, with statistically significant difference (P＜0.05). The HR and MAP of the control group at T2, T3, T4, T5 were higher than those at T1 in the group, with statistically significant differences (P＜0.05). The HR of the observation group at T1, T3, T5 was lower than that of the control group in the same period, with statistically significant difference (P＜0.05). The MAP of the observation group at T1 was higher than that of the control group in the same period, with statistically significant difference (P＜0.05). The MAP of the observation group at T5 was lower than that of the control group in the same period, with statistically significant difference (P＜0.05). There was no tatistically significant difference in mini-mental state examination (MMSE) score of the observation group between 1 day after surgery and 2, 3, 7 days after surgery (P＞0.05). The MMSE score of the control group on 2, 3, 7 days after surgery was higher than that on 1 day after surgery in the group, with statistically significant difference (P＜0.05). The MMSE score of the observation group on 1,2 days after surgery was higher than that of the control group in the same period,with statistically significant difference(P＜0.05). There was no tatistically significant difference in MMSE score of the two groups were compared on 1, 2 days after surgery (P＞0.05). Conclusion Deep anesthesia under closed loop target-controlled infusion can promote the stability of hemodynamics and the recovery of postoperative cognitive function in elderly patients with general anesthesia.

Key words： Closed-loop target-controlled infusion Different depth of anesthesia General anesthesia Hemodynamics;Cognitive dysfunction

Received: 29 July 2021

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NI Lin-hua. Effects of different anesthesia depths under closed circle target-controlled infusion on intraoperative hemodynamics and postoperative cognitive dysfunction in elderly patients under general anesthesia[J]. 中国当代医药, 2021, 28(35): 19-22.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I35/19

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