Department of Anesthesia, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China.
Department of Anesthesia, The Second People's Hospital of Hefei, Hefei, Anhui 230011, China.
Comput Math Methods Med. 2022 Oct 11;2022:2866188. doi: 10.1155/2022/2866188. eCollection 2022.
This research is designed to probe into the influence of Narcotrend- (NT-) assisted anesthesia in-depth monitor on cognitive impairment of elderly patients under general anesthesia (GA).
One hundred and forty-four elderly patients with GA in our hospital from October 2020 to April 2021 were randomized into two groups, namely, NT group (supervised anesthesia under NT monitoring) and group C (anesthesia according to doctors' experience). The heart rate (HR), mean arterial pressure (MAP), and central venous pressure (CVP) were recorded before surgery (T0), at the beginning of surgery (T1), at the end of surgery (T2), and 1 day after surgery (T3). Serum of patients was obtained at these four time points for measurements of C-reactive protein (CRP), interleukin-6 (IL-6), and cortisol (Cor) levels using the enzyme-linked immunosorbent assay (ELISA). The alterations in cognitive function pre- and post-anesthesia were assessed using the mini-mental state examination (MMSE), and adverse events (AEs) during anesthesia recovery, postoperative recovery, and dosage of anesthetics were recorded.
At T1 and T2, MAP was higher and CVP was lower in NT group, versus group C. NT group presented higher CRP, IL-6, and Cor than group C at T1-T3. MMSE scores were higher in TN group than in group C at 12, 24, and 48 h after surgery. The incidence rates of postoperative cognitive dysfunction (POCD) and total AEs in group C were noticeably higher than those in NT group. Compared with group C, the time of anesthesia recovery, extubation, and postanesthesia care unit (PACU) residence in NT group reduced remarkably.
NT has little effect on the physical condition of elderly patients under GA, and can reduce the dosage of narcotic drugs and promote the recovery of patients from anesthesia, which has high clinical value.
本研究旨在探讨麻醉深度监测仪(Narcotrend-,NT-)辅助麻醉对老年全麻患者认知功能障碍的影响。
选取我院 2020 年 10 月至 2021 年 4 月行全麻的 144 例老年患者,随机分为 NT 组(NT 监测下指导麻醉)和 C 组(根据医生经验麻醉)。记录术前(T0)、手术开始时(T1)、手术结束时(T2)和术后 1 天(T3)的心率(HR)、平均动脉压(MAP)和中心静脉压(CVP)。在这四个时间点采集患者血清,采用酶联免疫吸附试验(ELISA)检测 C 反应蛋白(CRP)、白细胞介素-6(IL-6)和皮质醇(Cor)水平。采用简易精神状态检查(MMSE)评估麻醉前后认知功能的变化,记录麻醉恢复、术后恢复期间的不良反应(AE)和麻醉剂剂量。
T1 和 T2 时,NT 组 MAP 较高,CVP 较低,与 C 组相比。NT 组在 T1-T3 时 CRP、IL-6 和 Cor 水平高于 C 组。与 C 组相比,NT 组术后 12、24 和 48 h 时 MMSE 评分较高。C 组术后认知功能障碍(POCD)和总 AE 发生率明显高于 NT 组。与 C 组相比,NT 组麻醉恢复、拔管和麻醉后恢复室(PACU)停留时间明显缩短。
NT 对全麻老年患者的身体状况影响较小,可减少麻醉药物剂量,促进患者麻醉恢复,具有较高的临床价值。