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| 意识指数监测对脑微血管减压术患者术后早期恢复质量的影响 |
| Effect of index of consciousness monitoring on early recovery quality in patients after cerebral microvascular decompression |
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| DOI：10.12089/jca.2020.06.008 |
| 中文关键词: 意识指数 微血管减压术 早期恢复质量 |
| 英文关键词: Index of consciousness Microvascular decompression Early recovery quality |
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| 中文摘要: |
目的 本研究评价意识指数（IoC）监测即镇静（IoC1）联合镇痛（IoC2）监测对微血管减压术患者早期恢复质量的影响。
方法 选取择期行微血管减压术患者60例，男24例，女36例，年龄18～65岁，BMI 18～30 kg／m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者随机分为两组：无监测组（B组，n=30）和IoC监测组（I组，n=30）。两组均采用气管内全身麻醉，麻醉维持采用靶控输注丙泊酚、瑞芬太尼，B组根据患者BP和HR等生命体征调整丙泊酚和瑞芬太尼的浓度；I组调整丙泊酚和瑞芬太尼的浓度，维持IoC1值40~60，IoC2值30~50。术前1 d、术后3 d采用15项恢复质量评分量表（QoR-15量表）评估患者早期恢复质量。记录术中丙泊酚及瑞芬太尼用量，术后情况（苏醒时间、拔管时间、进食时间、下床时间、住院时间），以及术后补救镇痛和恶心呕吐等不良事件的发生情况。
结果 与B组比较，I组术后3 d早期恢复质量评分明显升高(P<0.05)，丙泊酚及瑞芬太尼用量明显减少(P<0.05)，苏醒时间及拔管明显明显缩短(P<0.05)。两组术后补救镇痛及恶心呕吐等不良事件发生率差异无统计学意义。
结论 意识指数IoC1与IoC2联合监测可以提高微血管减压术患者的早期恢复质量。 |
| 英文摘要: |
Ojective To evaluate the effect of the index of consciousness (IOC) monitoring, that is the combination of sedation (IoC1) and analgesia (IoC2) monitoring on the early recovery quality of patients with microvascular decompression.
Methods Sixty patients with elective microvascular decompression, 24 males and 36 females, aged 18-65 years, with a BMI of 18-30 kg／m2, falling into ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups by using random number table method: no monitoring group (group B) and IoC1 combined with IoC2 monitoring group (group I), 30 cases in each group. Intratracheal general anesthesia was performed in both groups. Anesthesia was maintained by target-controlled infusion of propofol and remifentanil. Group I adjusted the concentration of propofol and remifentanil to maintain IoC1 40-60, and IoC2 30-50. Group B adjusted the concentrations of propofol and remifentanil according to vital signs such as blood pressure and heart rate. A 15-item Quality of Recovery Scale (QoR-15 scale) was used to assess the quality of recovery 1 day before operation and on the 3rd day after operation. The dosage of propofol and remifentanil during the operation, postoperative conditions (awakening time, extubation time, eating time, time of getting out of bed, discharge time), and the occurrence of adverse events in PACU such as postoperative remedial analgesia, nausea and vomiting recorded.
Results Compared with group B, the score of early recovery quality of patients in group I was higher on the 3rd after operation (P < 0.05). Compared with group B, the dosage of propofol and remifentanil was reduced in group I (P < 0.05). The awakening time and extubation time were significantly shortened in group I than those in group B (P < 0.05). The incidence of postoperative remedial analgesia, nausea and vomiting in PACU was not statistically significant in the two groups.
Conclusion Sedation (IoC1) combined with analgesia (IoC2) monitoring can improve the early recovery quality of patients with microvascular decompression. |
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