麻醉深度对成人腹部手术全麻患者脑代谢水平的影响

Effect of Depth of Anesthesia on Brain Metabolism in Adult Patients undergoing General Anesthesia for Abdominal Surgery

目的观察麻醉深度对成人腹部手术全麻患者脑代谢水平的影响。方法收集2017-2019年于开原市中心医院接受腹部手术治疗的患者150例,随机分为浅麻醉组和深麻醉组各75例。两组患者均采用全麻方式,术中以脑电双频指数(BIS)监测麻醉深度,浅麻醉组BIS在50~59,深麻醉组BIS在30~39。比较两组患者麻醉诱导前(T0)、插管前(T1)、插管后(T2)、手术前(T3)、手术后(T4)和拔管时(T5)脑动脉-静脉血氧含量差(Da-jvO2)和脑氧摄取率(CERO2)。结果组内比较:浅麻醉组和深麻醉组不同时间点Da-jvO2和CERO2差异均有统计学意义(P<0.05)。组间比较:浅麻醉组和深麻醉组T0时间点Da-jvO2和CERO2差异无统计学意义(P>0.05);而其余时间点Da-jvO2和CERO2差异均有统计学意义(P<0.05)。结论麻醉深度与脑代谢水平存在一定关系,即麻醉程度越深脑代谢水平越低。

Objective To observe the effect of depth of anesthesia on brain metabolism.Methods A total of 150 patients who underwent abdominal surgery in our hospital from 2017 to 2019 were randomly divided into shallow anesthesia group and deep anesthesia group,75 cases in each group.The depth of anesthesia was monitored by bispectral electroencephalogram index(BIS)during the operation.The BIS of shallow anesthesia group was 50~59,and that of deep anesthesia group was 30~39.The cerebral extraction ratio for oxygen(CERO2)of cerebral arteriovenous O2 content difference(Da-jvO2)before anesthesia induction(T0),before intubation(T1),after intubation(T2),before operation(T3),after operation(T4)and during extubation(T5)were compared between the two groups.Results There were significant differences in Da-jvO2 and CERO2 between shallow anesthesia group and deep anesthesia group at different time points(P<0.05).There was no significant difference in Da-jvO2 and CERO2 between shallow anesthesia group and deep anesthesia group at T0 time point(P>0.05),while there were significant differences in Da-jvO2 and CERO2 at other time points(P<0.05).Conclusion There is a certain relationship between the depth of anesthesia and the level of brain metabolism,that is,the deeper the degree of anesthesia,the lower the level of brain metabolism.