在接受胃肠道内镜治疗的老年患者中术后认知功能障碍:使用加工电脑图的观察性研究
Christopher P Potestio1, John Dibato2, Kelly Bolkus3
1Department of Anesthesiology, Cooper Medical School of Rowan University, Camden, USA.
Cureus
|November 7, 2023
概括
在胃肠道手术中使用普罗波福镇静剂时对患者状态指数 (PSI) 的监测与术后认知功能障碍 (POCD) 没有相关性. 通过PSI测量的更深度镇静,在接受这些手术的老年人中没有预测POCD.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 老年病的医生 老年病的医生
背景情况:
- 普罗波是胃肠道 (GI) 程序的常见镇静剂.
- 患者状态指数 (PSI) 是一种经过处理的脑电图 (EEG) 参数,用于镇静监测.
- 对意识的客观评估可能会改善胃肠道手术期间的镇静剂定位.
研究的目的:
- 研究通过PSI (PSI<26) 评估的深度镇静与手术后认知功能障碍 (POCD) 的发展或恶化之间的相关性.
- 评估客观的EEG监测是否可以预测GI手术后的认知变化.
主要方法:
- 一项务实,双盲的观察性研究,涉及400名年龄≥65岁的患者接受肠道内镜检查.
- 使用普罗波镇静剂,在整个过程中,患者使用SedLine®脑功能监测器 (PSI) 监测患者.
- 认知功能在基线和手术后1,7和90天使用短祝福测试 (SBT) 进行评估.
主要成果:
- 在PSI参数和SBT得分变化之间没有发现显著的相关性 (p>0.05).
- 在第七天观察到SBT得分的显著下降,与更高的年龄有关.
- 深度镇静 (PSI<26) 并没有预测SBT得分的变化;性别,普罗波福尔剂量和血管活性药物使用也没有预测.
结论:
- 使用普罗波镇静剂进行胃肠道手术后POCD的发生率很低 (7天后1.3%,90天后2.95%),低于基线.
- 年龄与SBT得分的小平均下降有关.
- 根据PSI的指示,更深的镇静与SBT测量的POCD变化无关.
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