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[1]高 珊,周 宁,陈春龙,等.不同Narcotrend分级指导下全身麻醉对老年腹部手术患者术后认知功能的影响[J].医学研究与战创伤救治(原医学研究生学报),2014,16(01):14-17.
　GAO Shan,ZHOU Ning,CHEN Chun-long,et al.Influence of dose depth of anesthesia assessed by the Narcotrend index on postoperative cognitive dysfunction in elderly patients after abdominal surgery[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2014,16(01):14-17.
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不同Narcotrend分级指导下全身麻醉对老年腹部手术患者术后认知功能的影响()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第16卷
期数:
2014年01期
页码:
14-17
栏目:
出版日期:
2014-02-20

文章信息/Info

Title:
Influence of dose depth of anesthesia assessed by the Narcotrend index on postoperative cognitive dysfunction in elderly patients after abdominal surgery
作者:
高 珊; 周 宁; 陈春龙; 戴海滨; 刘 健; 李伟彦
210002 江苏南京，南方医科大学南京临床学院(南京军区南京总医院)麻醉科
Author(s):
GAO Shan; ZHOU Ning; CHEN Chun-long; DAI Hai-Bin; LIU Jian; LI Wei-yan.
Nanjing Clinical School of Southern Medical University,Department of Anesthesiology,Nanjing General Hospital of Nanjing Military Command,Nanjing,Jiangsu 210002,China
关键词:
老年; 术后认知功能障碍; 麻醉深度; Narcotrend分级
Keywords:
elderly;  postoperative cognitive dysfunction;  depth of anesthesia;  Narcotrend index
分类号:
R614.2
DOI:
-
文献标志码:
A
摘要:
目的 探讨不同麻醉趋势(Narcotrend)分级指导下的全身麻醉对老年腹部手术患者术后认知功能的影响。方法 择期全麻下行腹部手术老年患者150例，随机均分为三组(A、B和C组)。以咪达唑仑0.05 mg/kg、丙泊酚1 mg/kg、瑞芬太尼2 μg/kg及罗库溴铵0.6 mg/kg诱导气管插管，术中以瑞芬太尼0.15 μg/(kg·min)、顺式阿曲库铵及丙泊酚维持麻醉。调节丙泊酚泵注速度使A、B、C三组麻醉深度维持至相应水平(D0 64~57、D1 56~47、D2 46~37)。记录手术期间的Narcotrend分级(NT)及指数(NI)，采用BIS作为平行对照。同时记录患者苏醒睁眼时间、拔管时间及各个时间点的心率和血压变化。分别于术前1 d和术后第7天使用简易精神状态量表(MMSE)及蒙特利尔认知功能量表(MoCA)对患者进行认知功能评估。结果 ①A、B和C组患者术后认知功能障碍(POCD)发生率分别为20.8%、15.2%和13.3%，差异无统计学意义(P>0.05)。②A、B和C组患者术前及术中各个时间点的心率和血压比较差异无统计学意义(P>0.05)。③三组患者拔管时间有显著差异(P<0.05)，B比A、C组苏醒拔管快。结论 不同Narcotrend分级指导下全身麻醉对老年患者腹部手术术后认知功能无显著影响，处于D1级麻醉深度时苏醒拔管早。
Abstract:
Objective To determine among the Narcotrend-assisted anaesthesia in Narcotrend stages D (general anesthesia),which level is better than the other on a measurement of postoperative cognitive dysfunction (POCD).Methods 150 patients were randomized into three groups (A,B,C,n=50).Endotracheal intubation was performed with midazolam 0.05 mg/kg,Propofol 1 mg/kg,emifentanil 2 μg/kg,rocuronium 0.6 mg/kg.Propofol and remifentanil were used for maintenance of anaesthesia.The values of the Narcotrend index were recorded continuously.A battery of neuropsychological tests was performed and scored preoperatively and 7 days after operation.Results The rate of POCD was 20.8%,15.2% and 13.3% of patients in A,B and C group,respectively.There was no difference in hemodynamics among groups at each time point (P>0.05).The extubation time and recover time have no difference in each group either.Conclusion Guidance of anaesthesia with the Narcotrend-monitor did not able to detect a significant association between the depth of anaesthesia and the rate of POCD 1 week after the surgery.

参考文献/References:

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备注/Memo

备注/Memo:
南京军区面上课题(2011034)
更新日期/Last Update: 2014-01-20