在急诊外科手术中透监测,突发抑制和早期术后认知功能障碍之间的关联:回顾性队列研究
Liliana Mirea1,2, Ana Maria Dumitriu2, Cristian Cobilinschi1,2
1Faculty of Medicine, "Carol-Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Journal of clinical medicine
|February 13, 2026
概括
在紧急手术中,经过处理的EEG监测可以优化麻醉并改善血液动力学. 然而,经BSR指示的手术内爆发抑制与早期术后狂妄风险的增加有关.
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:
- 紧急手术患者面临急性术后妄想症的风险增加.
- 经过处理的脑电图 (EEG) 监测,包括度指数和爆发抑制比率 (BSR),可以改进麻醉剂的使用,但在非选择性环境中尚未研究.
研究的目的:
- 调查监测,手术内突发抑制和急诊手术后72小时内早期术后狂妄的发生率之间的关联.
主要方法:
- 成年紧急手术患者的回顾性队列研究 (2022年3月至2024年3月).
- 患者被分为监测 (EG) 和标准护理 (SG) 组.
- 使用NEECHAM分数评估认知功能;分析了麻醉剂量,突发抑制和血液动力学.
主要成果:
- 被透监测的患者接受了较低的血和芬太尼剂量,血液动力稳定性得到改善,血管压缩剂需求减少.
- 在手术内抑制爆发的患者中观察到较高的早期术后狂妄发作 (NEECHAM ≤24).
- BSR>15%或抑制持续时间>6分钟与72小时的认知衰退有很强的相关性.
结论:
- 在紧急手术中,以透指导的麻醉可促进精确的麻醉定位和血液动力学稳定性.
- 术内突发抑制模式可能表明神经认知脆弱性,而不是直接的麻醉效应.
- 经过处理的EEG监测显示了紧急手术的前景,这需要进一步的前性调查.
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