Ning Meng, Sun Yue, Zhang Hao, Chen Caiyun, Sun Linglu, Chen Lijian, Xia Zhengyuan, Lu Yao
Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
Front Pharmacol. 2022 Sep 16;13:972793. doi: 10.3389/fphar.2022.972793. eCollection 2022.
This study aimed to compare the effects of different depths of sedation during propofol anesthesia on postoperative recovery 24 h after knee arthroscopy day surgery in adult patients. This prospective randomized controlled trial involved 126 patients (ASA physical status 1-2) who were scheduled to undergo arthroscopic day surgery. Patients were randomly divided into two groups: the light-sedation (L-Group) or deep-sedation (D-Group). In the L-group, the bispectral index values were kept in the range of 50-59; in the D-group, the bispectral index values were maintained in the range of 40-49. The Quality of Recovery-15 (QoR-15) score assessed 24 h postoperatively using a 15-item questionnaire was the primary outcome. Secondary outcomes included Athens Insomnia Scale scores, postoperative pain scores, nausea or vomiting. The total QoR-15 score 24 h postoperatively was similar in the two groups (L-group median:130, IQR [127-132] vs D-group median:131, IQR [126-135], = 0.089). But among the five dimensions of the QoR-15, physiological comfort was significantly better in the D-group than L-group ( < 0.001). The time to open eyes ( < 0.001), follow the command ( < 0.001) and to extubation ( < 0.001) after surgery in the L-group were shorter than the D-group. The Athens Insomnia Scale scores ( < 0.001) and incidence of dreaming ( = 0.041) at the first postoperative night in the L-group was significantly higher than those in the D-group. Propofol consumption in the L-group was less than D-group ( < 0.001). For patients undergoing arthroscopic day surgery, general anesthesia with high-bispectral-index (50-59) cannot improve the total QoR-15 score 24 h postoperatively after surgery, but can lessen propofol consumption, reduce the time of extubation and anesthesia recovery period, compared with low-bispectral-index (40-49). Patients exposed to general anesthesia with low-bispectral-index values (40-49) may have better quality sleep and physical comfort than those with high-bispectral-index values (50-59). http://www.chictr.org.cn/showproj.aspx?proj=126526, identifier ChiCTR2100046340.
本研究旨在比较成年患者膝关节镜日间手术后24小时丙泊酚麻醉期间不同镇静深度对术后恢复的影响。这项前瞻性随机对照试验纳入了126例计划接受关节镜日间手术的患者(美国麻醉医师协会身体状况1-2级)。患者被随机分为两组:浅镇静组(L组)和深镇静组(D组)。在L组中,脑电双频指数值保持在50-59范围内;在D组中,脑电双频指数值维持在40-49范围内。使用15项问卷在术后24小时评估的恢复质量-15(QoR-15)评分是主要结局。次要结局包括雅典失眠量表评分、术后疼痛评分、恶心或呕吐。两组术后24小时的QoR-15总分相似(L组中位数:130,四分位数间距[127-132];D组中位数:131,四分位数间距[126-135],P = 0.089)。但在QoR-15的五个维度中,D组的生理舒适度明显优于L组(P < 0.001)。L组术后睁眼时间(P < 0.001)、听从指令时间(P < 0.001)和拔管时间(P < 0.001)均短于D组。L组术后第一个晚上的雅典失眠量表评分(P < 0.001)和做梦发生率(P = 0.041)明显高于D组。L组丙泊酚用量少于D组(P < 0.001)。对于接受关节镜日间手术的患者,与低脑电双频指数(40-49)相比,高脑电双频指数(50-59)的全身麻醉不能改善术后24小时的QoR-15总分,但可减少丙泊酚用量,缩短拔管时间和麻醉恢复期。脑电双频指数值低(40-49)的全身麻醉患者可能比脑电双频指数值高(50-59)的患者有更好的睡眠质量和身体舒适度。http://www.chictr.org.cn/showproj.aspx?proj=126526,标识符ChiCTR2100046340 。