不同麻醉深度对幕上肿瘤手术患者术后认知功能的影响

Effects of different anesthesia depths on postoperative cognitive function in patients with supratentorial tumor surgery

摘要:

目的 评价不同麻醉深度对幕上肿瘤切除术患者术后认知功能的影响。方法 选取100例幕上肿瘤切除术患者并分为L组和D组，每组50例，L组脑电双频谱指数（BIS）控制在45~60，D组BIS控制在30~45。记录患者诱导前（T0）、置入气管导管前（T1）、切皮时（T2）、缝皮时（T3）、定向力恢复时（T4）的平均动脉压（MAP）、心率（HR），采用简易智能量表（MMSE）评定认知功能。结果 L组和D组T1~T3时MAP、HR显著低于T0时，差异有统计学意义（P<0.05），两组各时间点MAP、HR比较无明显差异（P>0.05）；D组术后第1、3天MMSE评分明显高于L组，差异有统计学意义（P<0.05），两组术后第7天MMSE评分比较差异无统计学意义（P>0.05）。结论 神经外科幕上肿瘤手术切除过程中，术中BIS值维持在30~45对患者术后早期的认知功能影响更小。

Abstract:

Objective To evaluate the effects of different anesthesia depths on postoperative cognitive function in patients undergoing supratentorial tumor resection.Methods One hundred patients undergoing supratentorial tumor resection were selected and divided into group L and group D, with 50 patients in each group. The electroencephalographic bispectral index (BIS) was kept between 45 and 60 in group L and between 30 and 45 in group D. Mean arterial pressure (MAP) and heart rate (HR) were recorded before induction (T0), before endotracheal tube placement (T1), and at the time of skin incision (T2), suture (T3), and recovery of orientation (T4). Cognitive function was assessed with the Mini-Mental State Examination (MMSE) scale.Results MAP and HR of groups L and D at T1-T3 were significantly lower than that at T0 (P<0.05); no significant differences in MAP and HR were observed between the two groups at any time point (P>0.05). Group D had significantly higher MMSE scores than group L at 1 and 3 days after operation (P<0.05), but no significant difference was observed at 7 days after operation (P>0.05).Conclusions During surgical resection of supratentorial tumors, BIS between 30 and 45 have less influence on the early postoperative cognitive function of patients.