七氟烷与异氟烷对老年腹部全麻手术患者BIS和Narcotrend指数的影响

目的:比较七氟烷与异氟烷对老年腹部全麻手术患者BIS、Narcotrend指数的影响。方法:将80例择期行老年腹部全麻手术患者随机分为舒芬太尼组与地佐辛组,每组40例患者。两组均给予常规麻醉诱导,对照组患者采用面罩吸氧给予异氟烷和舒芬太尼麻醉,试验组给予七氟烷和舒芬太尼麻醉。治疗结束后,对比分析两组入室前(t1)、手术完毕后(t2)、拔管时(t3)、拔管后5min(t4)、拔管后10min(t5)、拔管后1h(t6)的血流动力学、术后认知功能、脑电双频指数(BIS)、伤害趋势指数(NI)及不良反应的发生情况。结果:与对照组相比,试验组于t3~t4时心率较高(P0.05),试验组t3~t4简易精神状态检查(MMSE)评分较低,t2、t5~t6MMSE评分无显著差异,试验组于t3~t4时心率、BIS、NI水平较低(P0.05)。对照组不良反应发生率为10.01%,试验组为17.50%,组间差异无统计学意义(P0.05)。试验组手术部位感染发生率为12.50%(5/40)显著低于对照组(35.00%)(P0.05)。结论:七氟烷联合舒芬太尼收缩压以及舒张压的波动较小,下调BIS、Narcotrend指数,并于拔管后迅速恢复,降低SSI发生,安全性高。

Effects of BIS and Narcotrend index by Sevoflurane and Isoflurane in Elderly Patients with Abdominal General Anesthesia Operation

Objective:To compare the effects of sevoflurane and isoflurane on the BIS and Narcotrend index of elderly patients with abdominal general anesthesia operation.Methods:A total of 80 elderly patients with abdominal general anesthesia surgery were collected and randomly divided into the sufentanil group and dezocine group with 40 cases in each group, both groups were given general anesthesia induction, patients in the control group were treated by oxygen mask with 1.5%isoflurane + 6 L/min oxygen, sufentanil citrate injection (Sufentanil ) 4 ug/L. Patients in the experiment group were treated by 8%sevoflurane+6 L/min oxygen, sufentanil citrate injection (sufentanil ) 4 ug/L. The hemodynamic, postoperative cognitive function and bispectral index (BIS), the trend of damage index (Narcotrend), adverse reactions, and surgical site infections after treatment were compared bwteen two groups.Results:Compared with the control group, the HR of experiment group was higher at t3 ~ t4 (P<0.05), the MMSE score of experiment group was lower at t3 ~ t4, MMSE score had no significant difference at t2, t5 ~ t6, the HRBIS, NI levels of experiment group were lower at t3 ~ t4 (P < 0.05). The incidence rate of adverse reactions of control group was 10.08%, which was 17.50%the experiment group, there was no statistical significance between two groups(P>0.05). The incidence rate of surgical site infection of experiment group was 12.50% (5/40), which was significantly lower than that of the control group (35.00%, P<0.05).Conclusion:Sevoflurane combined with sufentanil had little effect on the systolic blood pressure and diastolic blood pressure, which could decrease the BIS and Narcotrend index, and quickly recovery after the extubation, reduce the SSI occur with high safety.