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不同的麻醉深度对瘤患者手术后认知功能的影响,由Narcotrend监测

Xueli Zhao¹, Ruina Guo², Xizhong Ma³

¹Department of Anesthesiology, The First Hospital of Xingtai, Xingtai, People's Republic of China.

Journal of neurological surgery. Part B, Skull base

|May 12, 2025

概括

对于老年胃肠癌手术患者,在麻醉期间保持30-39的Narcotrend指数 (NTI) 显著降低了术后认知功能障碍 (POCD). 这种深度麻醉方法改善了大脑的氧化代谢,减少了炎症反应,降低了POCD的发生率.

科学领域:

麻醉学麻醉学
老年医学老年医学
手术瘤学手术瘤学

背景情况:

手术后认知功能障碍 (POCD) 是接受重大手术的老年患者的一个重大问题.
胃肠道恶性瘤切除通常涉及长时间麻醉,增加POCD风险.
通过Narcotrend指数 (NTI) 监测的麻醉深度可能会影响外科手术后的结果.

研究的目的:

研究通过NTI监测的不同麻醉深度对经过胃肠癌手术的老年患者的POCD的影响.
评估与POCD相关的NTI,大脑氧化代谢和炎症标志物之间的相关性.

主要方法:

接受胃肠道瘤切除的老年患者被分为两个组:NTI 50-59 (对照组) 和NTI 30-39 (实验组).
认知功能使用迷你精神状态检查 (MMSE) 和血清S100β水平进行评估.
测量了大脑的氧化代谢 (rSO2,CERO2) 和炎症标志物 (TNF-α,IL-6).

主要成果:

与对照组相比,实验组 (NTI 30-39) 显示了较高的rSO2,较低的CERO2和降低的TNF-α和IL-6水平.
深度麻醉 (NTI 30-39) 与较低的S100β,较高的MMSE得分和较低的POCD发病率有关.
年龄和NTI分数都被确定为POCD的独立风险因素.

结论:

对于接受胃肠道瘤手术的老年患者,在麻醉期间保持30-39的NTI可以减少早期的术后POCD.
这种效应很可能是通过改善外科手术期间大脑氧化代谢和减弱炎症压力来调节的.
使用NTI进行麻醉深度监测是缓解POCD在这种患者群体中的一个有价值的工具.

关键词:

毒品趋势指数毒品趋势指数这是POCD的POCD.麻醉是一种麻醉.大脑的氧气代谢这是一种炎症炎症炎症炎症.

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