不同麻醉深度对中老年全麻患者围术期心率变异性和血流动力学的影响。

Effect of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia.

机构信息

Department of Anesthesiology, Affiliated Hospital of Putian University, Putian, China.

Department of Anesthesiology, The School of Clinical Medicine, Fujian Medical University, The First Hospital of PuTian City, No. 449, Nanmen West Road, Chengxiang District, Putian City, Fujian Province, 351100, China.

出版信息

BMC Anesthesiol. 2024 Sep 6;24(1):312. doi: 10.1186/s12871-024-02700-9.

DOI:10.1186/s12871-024-02700-9

PMID:39243005

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11378510/

Abstract

BACKGROUND

To analyze the effects of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, and to provide a basis for clinical application.

METHODS

A total of 111 patients with gastric cancer who were treated with epidural anesthesia combined with general anesthesia were selected as the study subjects, and the patients were randomly divided into group A, group B and group C. The bispectral index (BIS) was maintained by adjusting the infusion speed of anesthetics, the BIS of group A was maintained at 50 ~ 59, the BIS of group B was maintained at 40 ~ 49, and the BIS of group C was maintained at 30 ~ 39. The high-frequency power (HFP), low-frequency power (LFP), total power (TP), mean arterial pressure (MAP), heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) were measured before anesthesia induction (T1), immediately after intubation (T2), 3 min after intubation (T3), and 6 min after extubation (T4). The cognitive function of the patients was evaluated before and 48 h after surgery.

RESULTS

The HFP, LFP/HFP, TP, HR, DBP and SBP between the three groups at T1 ~ T3 are significantly difference from each other (P < 0.05). There were significant differences in spontaneous breathing recovery time, eye opening time and extubation time among group A, B and C groups, and group B had the lowest spontaneous breathing recovery time, eye opening time and extubation time (P < 0.05). There was no significant difference in the incidence of adverse reactions during anesthesia between the three groups. The cognitive function score of group B was significantly higher than that of group A and group C (P < 0.05).

CONCLUSIONS

BIS maintenance of 40 ~ 49 has little effect on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, which is helpful for postoperative recovery.

摘要

背景

分析不同麻醉深度对中老年全麻患者围术期心率变异性和血流动力学的影响，为临床应用提供依据。

方法

选取 111 例行硬膜外麻醉复合全麻的胃癌患者作为研究对象，随机分为 A、B、C 三组，通过调整麻醉药物的输注速度维持脑电双频指数（BIS），A 组 BIS 维持在 50~~59，B 组 BIS 维持在 40~~49，C 组 BIS 维持在 30~39。分别于麻醉诱导前（T1）、插管即刻（T2）、插管后 3min（T3）、拔管后 6min（T4）测量患者高频功率（HFP）、低频功率（LFP）、总功率（TP）、平均动脉压（MAP）、心率（HR）、舒张压（DBP）、收缩压（SBP），评估患者术前及术后 48h 的认知功能。

结果

三组患者 T1~T3 时 HFP、LFP/HFP、TP、HR、DBP、SBP 比较差异均有统计学意义（P<0.05）；A、B、C 三组患者自主呼吸恢复时间、睁眼时间、拔管时间比较差异均有统计学意义（P<0.05），B 组自主呼吸恢复时间、睁眼时间、拔管时间最短（P<0.05）；三组患者麻醉期间不良反应发生率比较差异无统计学意义（P>0.05）；B 组认知功能评分明显高于 A、C 组（P<0.05）。