Department of Gastrointestinal Surgery, The First Hospital of Xingtai, No. 376, Shunde Road, Xiangdu District, Xingtai, 054000, China.
Department of Anesthesiology, The First Hospital of Xingtai, Xingtai, 054000, China.
BMC Anesthesiol. 2024 Oct 14;24(1):371. doi: 10.1186/s12871-024-02762-9.
The purpose of this research was to evaluate the efficacy of Narcotrend (NT) monitoring on cognitive dysfunction in patients undergoing anesthesia blockade for gastrointestinal tumors and its effect on cerebral oxygen metabolism and inflammatory response.
Patients preparing to undergo resection of gastrointestinal tumor resection were included and randomly divided into a control group (depth of anesthesia assessed by physician experience) and a research group (depth of anesthesia monitored by NT). HR and MAP were monitored at the preoperatively (T), 12 h postoperative (T), 24 h postoperative (T), and 48 h postoperative (T) stages. MMSE score was recorded to assess changes in cognitive function. Intracerebral oxygenation indicators (CjvO, CERO and rSO) were assessed by a blood gas analyzer. ELISA assay was conducted to explore the serum inflammatory indexes (CRP, IL-1β, and TNF-α) and neurological function indicators (NSE and MBP).
MAP was higher in the research group than in the control group at T and T (P < 0.05). MMSE scores at T1, T2, and T3 stages were higher in the research group than in the control (P < 0.05). The incidence of POCD was also lower in the research group compared with the control (P < 0.05). CjvO, CERO and rSO were significantly higher (P < 0.05) and were positively correlated with the MMSE scores. Postoperative serum inflammatory indexes were significantly elevated in both groups, but more significantly in the control group (P < 0.05). Both neurological function indicators were usually reduced after surgery, but the reduction was more significant in the research group (P < 0.05).
NT monitoring of anesthetic depth has a less physical impact on patients with gastrointestinal tumor anesthetic block, reduces the degree of postoperative POCD, and has significant clinical value.
本研究旨在评估 Narcotrend(NT)监测对接受胃肠肿瘤麻醉阻滞的患者认知功能障碍的疗效及其对脑氧代谢和炎症反应的影响。
纳入拟行胃肠肿瘤切除术的患者,随机分为对照组(麻醉深度由医师经验评估)和研究组(NT 监测麻醉深度)。监测术前(T)、术后 12 小时(T)、术后 24 小时(T)和术后 48 小时(T)的心率(HR)和平均动脉压(MAP)。记录简易精神状态检查表(MMSE)评分,评估认知功能变化。血气分析仪评估颅内氧合指标(CjvO、CERO 和 rSO)。酶联免疫吸附试验(ELISA)检测血清炎症指标(CRP、IL-1β 和 TNF-α)和神经功能指标(NSE 和 MBP)。
T 和 T 时研究组的 MAP 高于对照组(P<0.05)。研究组 T1、T2 和 T3 时的 MMSE 评分均高于对照组(P<0.05)。研究组术后认知障碍(POCD)发生率低于对照组(P<0.05)。CjvO、CERO 和 rSO 明显升高(P<0.05),与 MMSE 评分呈正相关。两组术后血清炎症指标均明显升高,但对照组升高更明显(P<0.05)。两种神经功能指标术后通常均降低,但研究组降低更明显(P<0.05)。
NT 监测麻醉深度对胃肠肿瘤麻醉阻滞患者的身体影响较小,降低术后 POCD 程度,具有显著的临床价值。