BIS监测TCI全麻对妇科腹腔镜手术术中知晓和术后恢复的影响
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摘要
目的分析妇科腹腔镜手术采用BIS监测TCI全麻对术中知晓以及术后恢复的影响。方法选取102例我院于2017年4月～2018年4月接受腹腔镜手术治疗的妇科患者,作为本次研究的对象,根据数字表法随机将其分为参照组和研究组,参照组51例通过血流动力学对其用药情况进行调节,研究组51例根据BIS值变化调节用药,比较两组术中知晓情况、术后恢复情况以及麻醉前后对认知功能的影响。结果分析数据,麻醉前,两组认知功能(MMSE)评分比较,差异无统计学意义(P> 0.05);麻醉后,研究组认知功能(MMSE)评分变化不明显,与参照组比较,差异无统计学意义(P> 0.05);研究组术中知晓率为(1.96%),低于参照组术中知晓率(3.92%),差异无统计学意义(P> 0.05);研究组术后恢复情况,优于参照组术后恢复情况,差异有统计学意义(P <0.05)。结论对妇科腹腔镜手术通过BIS监测TCI全麻,应用价值优异,值得临床推广。
Objective To analyze the clinical effect of BIS monitoring TCI general anesthesia on intraoperative awareness and postoperative recovery in gynecologic laparoscopic surgery. Methods 102 gynecologic patients who underwent laparoscopic surgery in our hospital from April 2017 to April 2018 in our hospital were selected as research objects. According to the random number table principle, they were divided into reference group and study group. There were 51 patients in the reference group, whose medication was regulated by hemodynamics. There were 51 patients in the study group, whose medication was regulated according to the change of BIS value. The intraoperative awareness, postoperative recovery and the effect on cognitive function before and after anesthesia were compared between the two groups. Results By analyzing the data, there was no statistically significant difference in the cognitive function(MMSE) scores between the two groups before anesthesia(P > 0.05). After anesthesia, the cognitive function(MMSE) score of the study group did not change significantly. Compared with the reference group, the difference was not statistically significant(P > 0.05). The intraoperative awareness rate of the study group was 1.96%, which was lower than that of the reference group 3.92%. The difference was not statistically significant(P >0.05). The postoperative recovery of the study group was better than that of the reference group, and the difference was statistically significant(P < 0.05). Conclusion In gynecologic laparoscopic surgery, BIS monitoring TCI general anesthesia has excellent application value, which is worthy of clinical promotion.
Objective To analyze the clinical effect of BIS monitoring TCI general anesthesia on intraoperative awareness and postoperative recovery in gynecologic laparoscopic surgery. Methods 102 gynecologic patients who underwent laparoscopic surgery in our hospital from April 2017 to April 2018 in our hospital were selected as research objects. According to the random number table principle, they were divided into reference group and study group. There were 51 patients in the reference group, whose medication was regulated by hemodynamics. There were 51 patients in the study group, whose medication was regulated according to the change of BIS value. The intraoperative awareness, postoperative recovery and the effect on cognitive function before and after anesthesia were compared between the two groups. Results By analyzing the data, there was no statistically significant difference in the cognitive function(MMSE) scores between the two groups before anesthesia(P > 0.05). After anesthesia, the cognitive function(MMSE) score of the study group did not change significantly. Compared with the reference group, the difference was not statistically significant(P > 0.05). The intraoperative awareness rate of the study group was 1.96%, which was lower than that of the reference group 3.92%. The difference was not statistically significant(P >0.05). The postoperative recovery of the study group was better than that of the reference group, and the difference was statistically significant(P < 0.05). Conclusion In gynecologic laparoscopic surgery, BIS monitoring TCI general anesthesia has excellent application value, which is worthy of clinical promotion.
引文
[1]孙宇.脑电双频指数监测对全麻妇科腹腔镜手术镇静的指导作用[J].中国医疗器械信息,2018,24(10):108-109.
[2]刘荣伟.脑电双频指数监测下丙泊酚闭环靶控输注在腹腔镜胆囊切除术中的应用价值[J].中国药物经济学,2018,13(1):103-105.
[3]蔡兴涛,徐明禹,丁登峰,等.脑电双频指数对全麻下老年患者腹腔镜胃癌根治术术后认知功能障碍的影响[J].广东医学,2017,38(18):2793-2795.
[4]李志刚.脑电双频指数评估对老年腹腔镜手术麻醉患者平均动脉压、心率、pH、碱剩余、血糖的影响[J].中国老年学杂志,2017,37(16):4047-4049.
[5]徐夏.脑电双频指数监测下喉罩全身麻醉对腹腔镜胆囊切除术中血流动力学的影响[J].上海医学,2016,39(2):119-120.
[6]彭七华,罗怡君,张杰.脑电双频指数指导下行瑞芬太尼复合丙泊酚TCI麻醉在腹腔镜胆囊切除术中的应用效果分析[J].数理医药学杂志,2017,30(5):669-670.
[7]郝利娜,陈珂,鲁显福,等.脑电双频指数联合肌松监测在机器人辅助腹腔镜前列腺癌根治术老年患者中的应用[J].临床麻醉学杂志,2017,33(3):248-251.
[8]刘建军.脑电双频指数在腹腔镜手术麻醉中的观察[J].青海医药杂志,2016,46(11):10-11.
[9]钟剑洪,卫凤英,刘妙雯.BIS监测全麻对妇科腹腔镜手术术中知晓和术后恢复的影响[J].当代医学,2014,20(1):29-30.
[10]梁华娜,陈德全,林晓妹,等.脑电双频指数指导瑞芬太尼复合丙泊酚TCI在腹腔镜胆囊切除术中的应用[J].吉林医学,2015,36(18):4003-4004.
[11]陈健,衣起山.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[J].中国计划生育和妇产科,2016,8(7):68-70,78.
[12]高丽君,沈虹春,戎小平.两种全麻方式下二氧化碳气腹对老年妇科手术患者脑电双频指数和氧代谢的影响[J].浙江医学,2015,37(11):945-947+950.
[13]周纳武,马星钢,孟利刚.脑电双频指数及麻醉趋势指数在学龄前儿童腹腔镜手术中的变化[J].中国医药导报,2015,12(13):91-94.
[14]刘彬,姚爱军,冯祝余,等.脑电双频指数指导静脉全麻对高血压腹腔镜胆囊切除术患者苏醒质量的影响[J].现代医院,2015,15(4):24-26.
[15]吴雪兰.伤害性刺激指数与脑电双频指数导向靶控输注瑞芬太尼及异丙酚在腹腔镜手术中应用研究[J].陕西医学杂志,2015,44(4):468-469.
[16]徐夏,喻学海,彭蔚,等.BIS监测在喉罩麻醉下腹腔镜胆囊切除术中对血流动力学的影响[J].哈尔滨医科大学学报,2015,49(1):63-65.
[17]周纳武,马星钢,孟利刚.麻醉趋势指数、脑电双频指数与熵指数三种麻醉深度指数在学龄前儿童腹腔镜手术中的比较[J].黑龙江医学,2017,41(7):664-666.
[18]孔岚,周一.腹腔镜手术中脑电双频指数监测的临床意义[J].中国煤炭工业医学杂志,2013,16(11):1854-1855.
[19]刘云青,张冯江,孙凯,等.脑电双频指数监测对腹腔镜手术患者术后恢复的影响[J].国际麻醉学与复苏杂志, 2015, 36(5):394-397.
[20]刘济泳.脑电双频指数监测对腹腔镜手术患者麻醉质量的影响作用[J].中外医疗,2013,32(12):76-77.
[2]刘荣伟.脑电双频指数监测下丙泊酚闭环靶控输注在腹腔镜胆囊切除术中的应用价值[J].中国药物经济学,2018,13(1):103-105.
[3]蔡兴涛,徐明禹,丁登峰,等.脑电双频指数对全麻下老年患者腹腔镜胃癌根治术术后认知功能障碍的影响[J].广东医学,2017,38(18):2793-2795.
[4]李志刚.脑电双频指数评估对老年腹腔镜手术麻醉患者平均动脉压、心率、pH、碱剩余、血糖的影响[J].中国老年学杂志,2017,37(16):4047-4049.
[5]徐夏.脑电双频指数监测下喉罩全身麻醉对腹腔镜胆囊切除术中血流动力学的影响[J].上海医学,2016,39(2):119-120.
[6]彭七华,罗怡君,张杰.脑电双频指数指导下行瑞芬太尼复合丙泊酚TCI麻醉在腹腔镜胆囊切除术中的应用效果分析[J].数理医药学杂志,2017,30(5):669-670.
[7]郝利娜,陈珂,鲁显福,等.脑电双频指数联合肌松监测在机器人辅助腹腔镜前列腺癌根治术老年患者中的应用[J].临床麻醉学杂志,2017,33(3):248-251.
[8]刘建军.脑电双频指数在腹腔镜手术麻醉中的观察[J].青海医药杂志,2016,46(11):10-11.
[9]钟剑洪,卫凤英,刘妙雯.BIS监测全麻对妇科腹腔镜手术术中知晓和术后恢复的影响[J].当代医学,2014,20(1):29-30.
[10]梁华娜,陈德全,林晓妹,等.脑电双频指数指导瑞芬太尼复合丙泊酚TCI在腹腔镜胆囊切除术中的应用[J].吉林医学,2015,36(18):4003-4004.
[11]陈健,衣起山.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[J].中国计划生育和妇产科,2016,8(7):68-70,78.
[12]高丽君,沈虹春,戎小平.两种全麻方式下二氧化碳气腹对老年妇科手术患者脑电双频指数和氧代谢的影响[J].浙江医学,2015,37(11):945-947+950.
[13]周纳武,马星钢,孟利刚.脑电双频指数及麻醉趋势指数在学龄前儿童腹腔镜手术中的变化[J].中国医药导报,2015,12(13):91-94.
[14]刘彬,姚爱军,冯祝余,等.脑电双频指数指导静脉全麻对高血压腹腔镜胆囊切除术患者苏醒质量的影响[J].现代医院,2015,15(4):24-26.
[15]吴雪兰.伤害性刺激指数与脑电双频指数导向靶控输注瑞芬太尼及异丙酚在腹腔镜手术中应用研究[J].陕西医学杂志,2015,44(4):468-469.
[16]徐夏,喻学海,彭蔚,等.BIS监测在喉罩麻醉下腹腔镜胆囊切除术中对血流动力学的影响[J].哈尔滨医科大学学报,2015,49(1):63-65.
[17]周纳武,马星钢,孟利刚.麻醉趋势指数、脑电双频指数与熵指数三种麻醉深度指数在学龄前儿童腹腔镜手术中的比较[J].黑龙江医学,2017,41(7):664-666.
[18]孔岚,周一.腹腔镜手术中脑电双频指数监测的临床意义[J].中国煤炭工业医学杂志,2013,16(11):1854-1855.
[19]刘云青,张冯江,孙凯,等.脑电双频指数监测对腹腔镜手术患者术后恢复的影响[J].国际麻醉学与复苏杂志, 2015, 36(5):394-397.
[20]刘济泳.脑电双频指数监测对腹腔镜手术患者麻醉质量的影响作用[J].中外医疗,2013,32(12):76-77.