不同的麻醉深度对外科手术期间心率变化和血液动力学的影响,在接受全身麻醉的中年和老年患者中
Changbi Zhou1, Xiaoping Huang2, Zhifang Zhuo2
1Department of Anesthesiology, Affiliated Hospital of Putian University, Putian, China.
BMC anesthesiology
|September 6, 2024
概括
在全身麻醉期间保持双光谱指数 (BIS) 40-49对老年人血液动力学和心率变化影响最小. 这种麻醉深度与手术后恢复和认知功能的改善有关.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 老年医学 老年医学
背景情况:
- 一般麻醉的深度显著影响外科手术期间的血液动力学和自主神经系统活动.
- 中年和老年患者在麻醉期间存在独特的生理挑战.
- 优化麻醉深度对于尽量减少脆弱人群的不良结果至关重要.
研究的目的:
- 以双谱指数 (BIS) 为指导的不同麻醉深度对心率变化 (HRV) 和血液动力学参数的影响进行调查.
- 评估不同BIS水平对接受手术的老年患者的术后恢复和认知功能的影响.
- 建立一个临床基础,在这个患者队列中选择最佳的麻醉深度.
主要方法:
- 为胃癌手术进行全身麻醉的111名患者被随机分为三个BIS组:50-59 (A组),40-49 (B组) 和30-39 (C组).
- 术后血液动力学参数 (MAP,HR,DBP,SBP) 和HRV指数 (HFP,LFP,TP) 在定义的时间点进行测量.
- 评估了术后恢复指标 (自发呼吸,眼睛打开,输出时间) 和认知功能.
主要成果:
- 在诱导和维持麻醉期间,在BIS组中观察到HRV和血液动力学参数的显著差异 (P<0.05).
- 与A组和C组 (P<0.05) 相比,B组 (BIS 40-49) 的自发呼吸恢复,眼睛打开和输出时间显著缩短 (P<0.05).
- 与A组和C组相比,B组的认知功能得分显著更高 (P<0.05),但不良反应发生率没有显著差异.
结论:
- 在全身麻醉期间保持BIS在40-49之间对老年患者的外科手术期间心率变化和血液动力学影响很小.
- 针对BIS 40-49的麻醉深度与自发呼吸,眼睛打开和输出管的更快恢复有关.
- 这种BIS范围似乎有利于保持认知功能,并促进中老年和老年手术患者的术后恢复.
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