老年患者全麻苏醒期脑电双频谱指数对术后认知功能的影响

摘要

Objective To observe the relationship of awake bispectral index (BISawake) and the postoperative cognitive dysfunction (POCD). Methods 100 patients aged 60~75 years with ASA statusⅠ~Ⅱ, underwent elective lower abdominal surgery with intravenous an-esthesia (propofol, remifentanyl and rocuronium). The BIS was adjusted in 40~60 during the surgery. Their cognitive function was assessed with the neuropsychological test battery commended by International study of postoperative cognitive dysfunction (ISPOCD). Results 8 pa-tients withdrew for unwilling or serious complications. The BISawake was more than 65 in 68 patients (group A), and less than 65 in 24 pa-tients (group B). The difference of the verbal learning immediate and delayed of Hopkins Verbal Learning Test-Revised was more in the group B than in the group A. Conclusion Lower BISawake may be associated with the decline of postoperative cognitive function.%　　目的观察苏醒期脑电双频谱指数(BISawake)与术后认知功能的关系。方法100例60~75岁、ASAⅠ~Ⅱ级、行下腹部手术的老年患者，采用全静脉麻醉(丙泊酚、瑞芬太尼和罗库溴氨)。术中BIS控制在40~60。手术前后采用国际术后认知功能障碍研究协作组(ISPOCD)推荐的系列测试量表进行认知功能评估。结果8例患者由于不愿合作或出现严重并发症退出。BISawake与睁眼时间和拔管时间呈负相关。68例患者BISawake大于65(A组)，24例BISawake小于65(B组)，B组词语记忆和词语延迟记忆两项评分术前术后差值与A组相比增大(P<0.05)。结论 BISawake降低的患者可能预示着术后词语相关认知功能减退。