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基于脑电双频指数监测的麻醉深度对腹腔镜结直肠癌根治术患者的影响

Effects of Depth of Anesthesia Monitored by IoC on Patients Undergoing Laparoscopic Radical Resection of Colorectal Cancer.

作者信息

Zhao Jie, Kang Zhenming, Xie Wenqin, Lin Huimei, Liu Yang

机构信息

Department of Anesthesiology, Quanzhou First Hospital Affiliated to Fujian Medical University, No. 248-252 Dong Road, Quanzhou 362000, China.

出版信息

Mol Ther Methods Clin Dev. 2020 Jun 2;18:304-311. doi: 10.1016/j.omtm.2020.05.032. eCollection 2020 Sep 11.

Abstract

Index of consciousness (IoC) consisting of IoC1 and IoC2, is a new analgesia monitoring indicator in anesthesia evaluation in the laparoscopic radical resection of colorectal cancer. Although the precise anesthetic dosage adjusted by IoC1 has been confirmed to enhance the recovery and reduce the complications of anesthesia, the most appropriate range of IoC2 during anesthesia remains unclear. To investigate the correlation between IoC2 and peri-operative indicators of patients during laparoscopic radical resection of colorectal cancer, the current randomized, controlled, and single-blinded clinical trial was performed. Participants were divided randomly into three groups with different anesthesia depth monitored by IoC2 during their laparoscopic radical resections. Primary outcomes included the dosage of remifentanil. Secondary outcomes included other physiological indexes and complications. The remifentanil dosage and the awakening time increased as IoC2 decreased. The incidences of hypotension and hypoxemia decreased with the elevated IoC2, but the risk of intra-operative awareness also increased. The impact caused by anesthesia to the immune system and health-related life quality of the patients descended with reduced anesthetic level. The IoC2 range of 35-45 could represent the most appropriate anesthetic depth during laparoscopic radical resection, which provides a new perspective for the clinical treatment of colon cancer.

摘要

意识指数(IoC)由IoC1和IoC2组成,是腹腔镜结直肠癌根治术麻醉评估中的一种新的镇痛监测指标。尽管已证实由IoC1调整的精确麻醉剂量可促进恢复并减少麻醉并发症,但麻醉期间IoC2的最合适范围仍不清楚。为了研究IoC2与腹腔镜结直肠癌根治术患者围手术期指标之间的相关性,进行了当前的随机、对照、单盲临床试验。参与者在腹腔镜根治性切除术中被随机分为三组,通过IoC2监测不同的麻醉深度。主要结局包括瑞芬太尼的剂量。次要结局包括其他生理指标和并发症。随着IoC2降低,瑞芬太尼剂量和苏醒时间增加。低血压和低氧血症的发生率随着IoC2升高而降低,但术中知晓的风险也增加。麻醉对患者免疫系统和健康相关生活质量的影响随着麻醉水平降低而下降。35-45的IoC2范围可能代表腹腔镜根治性切除术中最合适的麻醉深度,这为结肠癌的临床治疗提供了新的视角。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/300e/7330423/e55679ebbd19/fx1.jpg

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