摘要
目的分析老年骨科手术患者开展脑电双频指数监测麻醉的作用。方法选取2020年1月至2021年12月苏州大学附属常熟医院收治的86例骨科手术老年患者作为研究对象,采用随机摸红蓝球方式将其分为常规组(43例)和试验组(43例),其中摸红球为常规组,摸蓝球为试验组。常规组患者依据麻醉医师临床工作经验和患者自身情况对麻醉深度进行调节,试验组患者在常规组的基础上加用脑电双频指数对麻醉深度实施精细化调节。比较两组患者的手术后拔管时间,苏醒时间,麻醉前、手术30 min、手术完成时的镇静程度、心率水平,手术前24 h、手术后24、72 h的简易智力状态检查量表(MMSE)得分以及谵妄出现率。结果试验组患者的手术后拔管时间以及苏醒时间均短于常规组,差异有统计学意义(P<0.05)。试验组患者手术30 min、手术完成时的镇静得分均低于常规组,差异有统计学意义(P<0.05)。试验组患者手术30 min、手术完成时的心率均低于常规组,差异有统计学意义(P<0.05)。试验组患者手术后谵妄出现率低于常规组,差异有统计学意义(P<0.05)。试验组患者手术后24、72 h的MMSE评分均高于常规组,差异有统计学意义(P<0.05)。结论老年骨科手术患者开展脑电双频指数监测调节麻醉状态能够缩短术后拔管和苏醒时间,维持心率水平稳定,改善认知功能异常情况,获得有效镇静,减少谵妄。
Objective To analyze the effect of bispectral index monitoring anesthesia in elderly patients undergoing orthopedic surgery.Methods A total of 86 elderly patients with orthopedic surgery admitted to Changshu Hospital Affiliated to Soochow University from January 2020 to December 2021 were selected as the research objects.They were randomly divided into the conventional group(n=43)and the experimental group(n=43)by touching red and blue balls.Patients in the conventional group were adjusted according to the clinical work experience of anesthesiologists and patients'own conditions,while patients in the experimental group were added to the conventional group with dual-frequency index to fine-adjust the depth of anesthesia.The postoperative extubation time,recovery time,sedation before anesthesia,30 min after operation,and at the completion of operation,heart rate,mini-mental state examination(MMSE)score 24 h before operation,24 h after operation,and 72 h after operation,and the incidence of delirium were compared between the two groups.Results The extubation time and recovery time of the experimental group were shorter than those of the conventional group,and the differences were statistically significant(P<0.05).The sedation scores at 30 min and the completion of operation in the experimental group were lower than those in the conventional group,and the differences were statistically significant(P<0.05).The heart rate of patients in the experimental group at 30 min after operation and at the completion of operation were lower than those in the conventional group,and the differences were statistically significant(P<0.05).The occurrence rate of postoperative delirium in the experimental group was lower than that in the conventional group,and the difference was statistically significant(P<0.05).The MMSE scores of the experimental group at 24 and 72 h after operation were higher than those of the conventional group,and the differences were statistically significant(P<0.05).Conclusion Bispectral index monitoring and adjustment of anesthesia in elderly patients undergoing orthopedic surgery can shorten the time of postoperative extubation and recovery,maintain the stability of heart rate,improve the abnormal cognitive function,obtain effective sedation,and reduce delirium.
作者
徐秋
汤程
XU Qiu;TANG Cheng(Department of Anesthesiology,Changshu Hospital Affiliated to Soochow University,Changshu No.1 People's Hospital,Jiangsu Province,Changshu 215500,China)
出处
《中国当代医药》
CAS
2022年第32期155-158,共4页
China Modern Medicine
关键词
骨科
麻醉
脑电双频指数
谵妄
镇静
Orthopedic
Anesthesia
Bispectral index
Delirium
Sedation
