机器人外科学杂志（中英文）2025，Vol.6Issue(2)：239-244,6.DOI:10.12180/j.issn.2096-7721.2025.02.009
脑电双频指数指导下丙泊酚闭环靶控输注麻醉在经口腔前庭入路机器人辅助甲状腺切除术中的应用
Closed-loop control of propofol anesthesia using bispectral index in patients undergoing transoral robot-assisted thyroidectomy vestibular approach
摘要
Abstract
Objective:To explore the effectiveness of closed-loop controlled propofol anesthesia using bispectral index in patients who underwent transoral robot-assisted thyroidectomy vestibular approach(TORTVA).Methods:120 patients who underwent TORTVA from June 2020 to June 2023 in the Second Affiliated Hospital of Air Force Military Medical University were selected,and they were divided into the study group(n=60,closed-loop controlled propofol anesthesia using bispectral index)and the control group(n=60,open-loop controlled infusion of propofol)using a random number table.The perioperative anaesthesia-related indexes,hemodynamic indexes,serum inflammation indexes,cognitive function,and adverse reactions were compared between the two groups of patients.Results:There was no significant difference in the anesthesia time between the two groups of patients(P＞0.05).Compared with the control group,the study group had shorter postoperative spontaneous respiratory recovery time,extubation time and awakening time,but lower propofol dosage and 24 h postoperative VAS score(P＜0.05).Repeated measures showed statistically significant differences in HR timepoint/interaction effect and MAP intergroup/interaction effect between the two groups of patients(P＜0.05).Compared with that before induction,HR and MAP were decreased at intubation,and MAP was decreased immediately at the end of surgery in the two groups(P＜0.05).Compared with the control group,the study group had higher HR and MAP at intubation,higher MAP and lower HR at immediate point after surgery(P＜0.05).Repeated measurements showed statistically significant differences in timepoint,intergroup,and interaction effect of CRP and IL-6 between the two groups of patients(P＜0.05).Compared with that before induction,levels of CRP and IL-6 were both increased in the two groups at immediate point after surgery,6 h and 24 h after surgery(P＜0.05).Compared with the control group,the CRP level of patients in the study group was lower at 6 h and 24 h after surgery,and IL-6 level was lower at the immediate point after surgery,6 h and 24 h after surgery(P＜0.05).Repeated measurements showed that the difference in the intergroup effect of MMSE scores between the two groups was statistically significant(P＜0.05).Compared with that before induction,MMSE scores were both decreased in the two groups 1 d after surgery(P＜0.05),and they were higher in the study group at 1 d and 3 d after surgery(P＜0.05).The total incidence of adverse reactions was lower in the study group than that in the control group(P＜0.05).Conclusion:Closed-loop control of propofol anesthesia using bispectral index in patients undergoing transoral robot-assisted thyroidectomy vestibular approach has a better anaesthesia effect,which can effectively stabilize hemodynamic indexes,alleviate inflammatory reactions,reduce cognitive impairment,and lower the incidence of adverse reactions.关键词
甲状腺切除术/机器人辅助手术/脑电双频指数Key words
Thyroidectomy/Robot-assisted Surgery/Bispectral Index分类
临床医学引用本文复制引用
李伟,汪鸿,刘伟娜,陈燕,张芳芳,牛晶..脑电双频指数指导下丙泊酚闭环靶控输注麻醉在经口腔前庭入路机器人辅助甲状腺切除术中的应用[J].机器人外科学杂志（中英文）,2025,6(2):239-244,6.基金项目
国家自然科学基金(81801391) National Natural Science Foundation of China(81801391) （81801391）
