Chen Wending, Zhong Shaoxiong, Ke Wenju, Gan Shuyuan
Department of Anesthesiology, The Obstetrics and Gynecology Hospital, College of Medicine, Zhejiang University Hangzhou City 310003, Zhejiang Province, China.
Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou City 310003, Zhejiang Province, China.
Am J Transl Res. 2021 Oct 15;13(10):11797-11805. eCollection 2021.
The purpose of this study was to examine the effects of various depths of anesthesia monitored using Narcotrend on cognitive function in elderly patients after video-assisted thoracic surgery (VATS) lobectomy.
A total of 73 elderly patients who underwent VATS lobectomy were selected and divided into a control group (n=36) and an observation group (n=37) using a random number table. Both groups received general anesthesia. The Narcotrend index (NTI) of the control group was maintained at 50-59 and that of the observation group was maintained at 30-39.
The heart period (HP) and mean arterial pressure (MAP) from both groups were decreased first, and then were increased during T-T; the MAP levels at T, T , and T were lower in the observation group than in the control group ( < 0.05). The propofol dosage was higher and the awake to extubation time was greater in the observation group than in the control group ( < 0.05). The visual analogue scale (VAS) score was lower in the observation group than in the control group at 6 h and 12 h after surgery ( < 0.05). The left and right regional cerebral oxygen saturation (rSO) at T -T was higher in the observation group and the cerebral oxygen extraction ratio (CERO) was lower in the observation group than in the control group ( < 0.05).
The anesthetic depth that maintained an NTI of 30-39 as monitored using Narcotrend could improve cerebral oxygen metabolism, inhibit the inflammatory reaction, and reduce the incidence of postoperative cognitive dysfunction (POCD) in patients after VATS lobectomy.
本研究旨在探讨使用脑电双频指数（Narcotrend）监测的不同麻醉深度对老年患者电视辅助胸腔镜手术（VATS）肺叶切除术后认知功能的影响。
选取73例行VATS肺叶切除术的老年患者，采用随机数字表法分为对照组（n = 36）和观察组（n = 37）。两组均接受全身麻醉。对照组的脑电双频指数（NTI）维持在50 - 59，观察组的NTI维持在30 - 39。
两组的心动周期（HP）和平均动脉压（MAP）均先下降，然后在T - T期间升高；观察组在T、T₁和T₂时的MAP水平低于对照组（P < 0.05）。观察组的丙泊酚用量高于对照组，清醒至拔管时间长于对照组（P < 0.05）。术后6 h和12 h时观察组的视觉模拟评分（VAS）低于对照组（P < 0.05）。观察组在T₁ - T₂时左右脑局部氧饱和度（rSO₂）高于对照组，脑氧摄取率（CERO）低于对照组（P < 0.05）。
使用Narcotrend监测维持NTI为30 - 39的麻醉深度可改善VATS肺叶切除术后患者的脑氧代谢，抑制炎症反应，并降低术后认知功能障碍（POCD）的发生率。
