中国中西医结合外科杂志2017，Vol.23Issue(5)：510-514,5.DOI:10.3969/j.issn.1007-6948.2017.05.013
麻醉深度对老年术后谵妄影响
Effect and Possible Mechanism Invitation of Anesthetic Depth on Postoperative Delirium in Elderly Pa-tients
齐孟娜 1吕国义2
作者信息
- 1. 天津医科大学总医院滨海医院麻醉科 天津 300480
- 2. 天津医科大学第二医院麻醉科 天津 300211
- 折叠
摘要
Abstract
Objective To observe the influence of different anesthesia depth on the postoperative delirium (POD) in senile patients under general anesthesia. Methods A total of 120 senile patients who were sched-uled for elective open cholecystectomy were randomized divided into total intravenous anesthesia (TIVA) group (group A) and inhalation anesthesia group (group B). Each of the two groups was further divided into two sub-groups according to Bispectral Index (BIS): group A1 and B1 with BIS from 40 to 49 and group A2 and B2 with BIS from 50 to 59. There were 30 patients in each subgroup. The baseline characteristics, mini mental state ex-amination (MMSE), incidence of delirium, serum neuron specific enolase (NSE) and astrocyte derived protein (S100β) concentration were recorded. Results The baseline characteristics and postoperative pain showed no significant difference between group A1 and A2 (P>0.05). The scores of MMSE were 24.13 days after surgery and 25.25 days after surgery in group A1, and 26.9 and 27.1 in group A2, respectively. The postoperative MMSE scores in group A1 were significantly lower than that in group A2 (P<0.05). Twenty percent of patients in group A1 had POD which were significantly higher than group A2 in which the POD incidence was 0 (P<0.05). Serum NSES and S100β concentration in group A1 and group A2 increased significantly from T0 to T1~3 (P<0.05). Compared to group A2, group A1 had higher serum NSES and S100β concentration at T1~3 (P<0.05). Group B was similar to group A regarding to baseline characteristics, MMSE, incidence of delirium, serum NSE and S100β concentration. Conclusion It is a better choice to keep BIS from 50 to 59 in lowering POD incidence in senile patients under general anesthesia, either TIVA, or inhalation anesthesia.关键词
麻醉深度/术后谵妄/七氟烷/丙泊酚/老年Key words
Depth of anesthesia/post-operative delirium/sevoflurane/propofol/elderly分类
医药卫生引用本文复制引用
齐孟娜,吕国义..麻醉深度对老年术后谵妄影响[J].中国中西医结合外科杂志,2017,23(5):510-514,5.
