脑电双频指数值监控镇静深度对妇科腹腔镜术后认知功能的影响

目的观察不同脑电双频指数(Bispectral index,BIS)值监测下对妇科腹腔镜术后认知功能的影响。方法选择2012年4月至2014年12月儋州市第一人民医院妇科择期行腹腔镜手术的患者80例,根据患者BIS值分为2组:A组(40BIS值≤50)42例和B组(50BIS值≤60)38例。简易精神状态量表(mini-mental state examination,MMSE)评价认知功能,患者疼痛程度评价使用视觉模拟评分法(visual analogue scale,VAS)。结果 A组麻醉后自主呼吸恢复时间(3.4±0.9)min]明显短于B组(5.2±1.6)min](P0.05)。A组麻醉后苏醒时间和拔管时间(7.7±2.4)min、(8.6±2.3)min]与B组(7.9±2.5)min、(8.4±2.7)min]比较差异无统计学意义(P0.05)。A组和B组麻醉前MMSE评分差异无统计学意义(P0.05),麻醉结束拔管1、3 h后MMSE评分两组均明显降低(P0.05),拔管24 h后两组MMSE评分恢复到麻醉前水平(P0.05)。其中麻醉结束拔管1 h后A组MMSE评分显著高于B组(P0.05),拔管3、24 h后两组的MMSE比较差异无统计学意义(P0.05)。A组七氟烷用量为(14.3±3.5)m L,显著低于B组的(18.5±4.8)m L(P0.05)。A组24 h后VAS评分为1.8±0.6,B组为1.7±0.5,两组比较差异无统计学意义(P0.05)。结论 40BIS值≤50组术后患者认知功能障碍较50BIS值≤60组轻,具有一定的临床应用价值。

The impact of monitoring sedation depth by different bispectral index value on postoperative cognitive function after gynecological laparoscopic surgery

Objective To observe the impact of monitoring sedation depth by different bispectral index (BIS) value on postoperative cognitive function after gynecological laparoscopic surgery.Methods 80 cases of patients who underwent laparoscopic surgery in Department of Anesthesiology of first people's Hospital in Danzhou from April 2012 to December 2014 were selected and divided into A group (40 ＜ BIS value ≤≤ 50,n =42)and B group (50 ＜ BIS value ≤ 60,n =38).The cognitive function was estimated by mini-mental state examination (MMSE) and soreness degree was estimated by visual analogue scale (VAS).Results The recovery time of respiratory depression of A group (3.4 ± 0.9) min] was shorter than that of B group (5.2 ± 1.6) min] (P ＜0.05).The recovery time of drowsiness and extubation time of A group (7.7 ± 2.4) min,(8.6 ± 2.3) min] had no significant differences with those of B group (7.9 ± 2.5) min,(8.4 ± 2.7) min] (P ＞ 0.05).The MMSE value before anesthesia between group A and group B had no significant difference(P ＞0.05),MMSE value decreased 1 h and 3 h after extubation(P ＜ 0.05),and recovered to the level before anesthetization 24 h after extubation.However,MMSE value in group A was higher than that in Bgroup 1 h after extubation for (P ＜ 0.05).No significant differences were found between A and B group 3 h and 24 h after extubation (P ＞ 0.05).The volume of isoflurane inhalation in group A was (14.3 ± 3.5) mL,which was lower than that in group B (18.5 ± 4.8) mL] (P ＜ 0.05).The VAS value in group A (1.8 ± 0.6) and group B (1.7 ± 0.5) had no significant difference (P ＞ 0.05).Conclusion The effect on postoperative cognitive function in 40 ＜ BIS value≤50 group is less than that in 50 ＜ BIS value≤60 group,which is worthy of clinical application.