原始脑电图指导麻醉剂对接受腹部大手术的老年患者手术后结果的影响:随机对照试验
Ziqing He1, Hao Zhang1, Yahui Xing1
1Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Hefei, Anhui Province, 230022, China.
BMC anesthesiology
|October 6, 2023
概括
老年患者的原始电脑电图 (rEEG) 指导麻醉并没有减少术后并发症,但优化了麻醉深度. 这种方法可以通过基于EEG模式的个性化麻醉管理来改善弱势患者的结果.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
背景情况:
- 脑电图 (EEG) 监测对于在外科手术期间评估镇静深度至关重要.
- 关于EEG衍生指数,如双光谱指数 (BIS) 对患者结局的影响也在争论中.
- 这项研究调查了原始EEG (rEEG) 指导麻醉对麻醉管理和患者结果的影响.
研究的目的:
- 确定EEG导向麻醉是否影响麻醉管理,并影响接受重大腹部手术的老年患者的术后结果.
- 探索EEG模式和术后并发症之间的关系.
主要方法:
- 141名接受重大腹部手术的老年患者 (≥60岁) 被随机分为EEG导向麻醉或常规护理组.
- EEG指导组:以保持在C-D镇静深度的EEG波形,提升了propofol的标位.
- 常规护理组:麻醉师使用临床判断而不使用rEEG波形数据.
主要成果:
- 在手术后的呼吸,循环,神经或胃肠道并发症中,两组之间没有显著差异.
- 较低的前额α功率与更高的术后痴呆症 (POD) 发病率有关.
- 在前额α功率较低的患者中,EEG指导减少了深度麻醉的持续时间,在前额α功率较高的患者中允许更深度麻醉.
结论:
- 在接受重大腹部手术的老年患者中,EEG导向麻醉并没有减少整体术后并发症.
- rEEG指导减少了手术内更深度麻醉的持续时间和过度镇静,特别是在前额α功率较低的患者中.
- EEG导向麻醉可以通过早期识别和个性化麻醉管理来提高脆弱患者的预后.
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