摘要
目的:分析以脑电双频指数(BIS)为指导的丙泊酚闭环靶控输注麻醉在机器人辅助胰十二指肠切除术中的临床应用效果。方法:回顾性选取2023年10月—2024年11月于西安交通大学第一附属医院接受机器人辅助胰十二指肠切除术的102例患者作为研究对象,根据麻醉方式不同分为对照组(n=51,采用丙泊酚开环输注麻醉)和研究组(n=51,采用BIS指导的丙泊酚闭环靶控输注麻醉)。比较两组患者围手术期指标、血流动力学指标、认知功能及不良反应发生率。结果:研究组麻醉维持时长、苏醒时长、拔管时间、自主呼吸恢复时间均显著短于对照组,丙泊酚用量显著少于对照组,术后24 h疼痛评分显著低于对照组(P<0.05)。两组患者麻醉诱导前(T0)、研究组闭环系统开启前/对照组丙泊酚输注30 min后(T1)的心率、平均动脉压比较,差异无统计学意义(P>0.05);研究组闭环系统开启后1 h/对照组丙泊酚输注1.5 h后(T2),研究组心率低于对照组,平均动脉压高于对照组;术毕即刻(T3),研究组心率低于对照组、平均动脉压高于对照组(P<0.05)。术前1 d两组简易精神状态量表(MMSE)评分无显著差异(P>0.05),术后1 d、3 d研究组MMSE评分显著高于对照组(P<0.05)。研究组不良反应发生率低于对照组(P<0.05)。结论:BIS指导下丙泊酚闭环靶控输注麻醉方式可加快机器人辅助胰十二指肠切除术后患者康复进程,减少丙泊酚用量,稳定血流动力学,改善术后认知功能,降低不良反应发生率。
Objective:To analyze the clinical efficacy of bispectral index(BIS)-guided closed-loop target-controlled infusion of propofol in robot-assisted pancreaticoduodenectomy(RAPD).Methods:A retrospective analysis was conducted on 102 patients who underwent RAPD in the First Affiliated Hospital of Xi’an Jiaotong University between October 2023 and November 2024.Patients were divided into the control group(n=51,receiving open-loop propofol infusion)and the study group(n=51,receiving BIS-guided closed-loop targetcontrolled infusion of propofol)based on anesthesia technique.Perioperative indicators,hemodynamic parameters,cognitive function,and adverse reaction rates were compared between the two groups.Results:The study group showed significantly shorter durations of anesthesia maintenance,emergence,extubation during recovery,and spontaneous breathing recovery compared to the control group(P<0.05).Propofol consumption and postoperative 24-hour pain scores was were significantly lower in the study group than the control group(P<0.05).There was no statistically significant difference in heart rate(HR)and mean arterial pressure(MAP)between the two groups at T0(before anesthesia induction)or at T1(30 minutes after propofol infusion in the control group/before closed-loop system activation in the study group)(P>0.05).At T2(1.5 hours after propofol infusion in the control group/1 hour after closed-loop system activation in the study group),the study group showed lower HR and higher MAP than the control group.At the immediate end of surgery(T3),the study group showed lower HR and higher MAP than the control group(P<0.05).No significant difference was observed in minimental state examination(MMSE)scores between the two groups one day after surgery(P>0.05),but the study group showed significantly higher MMSE scores at 1 day and 3 days after surgery compared to the control group(P<0.05).The incidence of adverse reactions was also lower in the study group than the control group(P<0.05).Conclusion:BIS-guided closed-loop target-controlled infusion of propofol can accelerate postoperative recovery,reduce propofol consumption,stabilize hemodynamics,improve postoperative cognitive function,and lower the incidence of adverse reactions in patients undergoing RAPD.
作者
谭文君
邢斌瑜
郭嘉雯
路璐
朱皓阳
TAN Wenjun;XING Binyu;GUO Jiawen;LU Lu;ZHU Haoyang(Department of Surgical Intensive Care Unit,the First Affiliated Hospital of Xi’an Jiaotong University,Xian 710061,China;Department of Anesthesia Surgery,the First Affiliated Hospital of Xi’an Jiaotong University,Xian 710061,China)
出处
《机器人外科学杂志(中英文)》
2025年第12期2060-2065,共6页
Chinese Journal of Robotic Surgery
基金
陕西省重点研发计划一般项目(2023-YBSF-421)。
