Narcotrend监测不同麻醉深度对老年肠癌患者术后早期认知功能障碍的影响.pdf

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1、临床麻醉学杂志2013年8月第29卷第8期JClinAnesthesiol，August2013，Vo1．29，No．8．临床研究．Narcotrend监测不同麻醉深度对老年肠癌患者术后早期认知功能障碍的影响康茵邓龙姣赵国栋刘红李海风田可耘【摘要】目的研究Narcotrend监测下三种不同麻醉深度对老年肠癌患者术后早期认知功能障碍(POCD)的影响。方法全身麻醉下行腹腔镜肠癌根治术的老年患者150例，年龄6O～92岁，ASAI～Ⅲ级，随机均分为三组，术中Nareotrend分级(NTS)分别维持在Do(A组)、D2(B组)或E(C组)。记录麻醉诱导前

2、(To)、气管插管前(T)、气管插管后即刻(T)、气腹前2min(T3)、气腹后2min(T4)、手术结束(T5)、拔管Hg(Ts)的HR、MAP。于术前1d和术后第7天对患者行认知功能评估，计算POCD发生率。结果与rr0时比较，T、～T。时A组HR明显增快(P

3、其中A组有19例(39．6)，B组有8例(16．7)，C组有11例(22．4)，A组POCD发生率明显高于B、C组(PG0．05)。结论老年腹腔镜肠癌根治术中将NTS维持在D2或E水平可降低术后早期POCD的发生率，且D2水平更有利于维持血流动力学的稳定。【关键词】麻醉深度；Narcotrend监测；老年；术后认知功能障碍Effectsofdifferentdepthsofanesthesiaoilearlypostoperativecognitivedysfunctioninelderlypatientsundergoingelectivelapa

4、roseopiesurgeryforeolorectalcancerKANGYin，DENGLong-jiao，ZHAoGuo-dong，LIUHong，LIH＆i·feng，TIANKe-yun．Departmento{Anesthesiology，GuangdongGeneralHospital，GuangdongAcademyofMedicalScience，Guangzhou510080，ChinaCorrespondingauthor：TIANKe—yun，Emaif：kdtvB01@hotmaif．com[Abstract]Objecti

5、veToinvestigatetheeffectsofthreedifferentdepthsofanesthesiaonearlypostoperativecognitivedysfunction(POCD)inelderlypatientsundergoingelectivelaparoscopicsurgeryforcolorectalcancer．MethodsAtotalof150ASAI一Ⅲpatientsaged60—92yearsundergoingelectivelaparoscopicsurgeryforcolorectalcan

6、cerwithgeneralanesthesiawererandomizedinto3groups，includinggroupA[anesthesiadepthmaintainedwiththetargetofNarcotrendstage(NTS)atDoleve1]，groupB(NTSatDoleve1)andgroupC(NTSatE11eve1)．HRandMAPvalueswererecordedbeforeanesthesiainduction(To)，beforeintubation(T])，immediatelyafterintu

7、bation(T2)，2minutesbeforepneumoperitoneum(T3)，2minutesafterpneumoperitoneum(T4)，attheendofsurgery(Ts)andatthetimeofextubation(I"6)．ThecognitivefunctionsofthepatientswereevaluatedIdaybeforeand7daysafterthesurgery．ResultsHRatT2，一ingroupAincreasedsignificantlycomparedtoTo，andtheyw

8、erealsosignificantlyhigherthantheHRatthesametimepointi