对老年患者进行非心脏手术的双光谱指数引导麻醉:一个随机的多中心试验
Li Zhou1, Lin Ding1, Hui Yang1
1Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Anesthesiology
|September 25, 2025
概括
双光谱指数 (BIS) 监测并没有改善老年手术患者的结果. 一年死亡率和30天并发症在BIS引导和常规麻醉管理组之间是相似的.
科学领域:
- 麻醉学 麻醉学
- 老年人手术是一门老年人手术.
- 临床试验 临床试验
背景情况:
- 老年手术患者面临的风险增加,因为与年龄相关的生理变化和并发症.
- 指南建议双光谱指数 (BIS) 监测以优化麻醉深度,但改善结果的证据有限.
研究的目的:
- 评估双光谱指数 (BIS) 导向麻醉管理对接受选择性非心脏手术的老年人1年全因死亡率的影响.
主要方法:
- 一个随机的,多中心的双盲试验涉及6,982名65岁以上的患者.
- 患者被分配到BIS指导 (目标BIS40-60) 或常规麻醉管理.
- 主要结局是1年全因死亡率;次要结局包括30天的并发症,功能独立和生活质量.
主要成果:
- 一年死亡率相似:BIS指导组的10.2%,常规组的10.0% (P=0.812).
- 30天的并发症率也相似 (10.4%对10.6%,P=0.938).
- 两组之间在功能独立或生活质量方面没有发现显著差异.
结论:
- 麻醉师似乎在没有BIS指导的情况下有效地管理催眠深度,在两组中保持相似的水平.
- 在该患者群体中,BIS监测并没有改善术后结果,包括死亡率和并发症.
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