Objective: To explore the effect of multiparameter electroencephalogram (EEG)-guided anesthesia management on EEG burst suppression (BS) and postoperative delirium (POD) in elderly patients undergoing lower abdominal laparoscopic surgery.
Methods: A total of 100 elderly patients, 48 males and 52 females, aged 65-85 years, BMI 18.5-28.0 kg/m2, and ASA physical status Ⅱ or Ⅲ, were enrolled for lower abdominal surgery under general anesthesia. Patients were randomly divided into two groups: multiparameter group and single parameter group, 50 patients in each group. In multiparameter group, multiparameter EEG monitoring with patient statu index (PSI), spectral edge frequency (SEF), burst suppression ratio (BSR) and density spectral array (DSA) were used to guide the depth management of anesthesia. In single parameter group, single parameter PSI was used to guide the depth management of anesthesia. The total area under the hypotensive threshold of MAP (AUTMAP) was calculated, and the amount of anesthetic used during the operation and the use of vasoactive drugs, duration of anesthesia, extubation time, duration of PACU stay, and postoperative hospitalisation days were recorded. HR, MAP, PSI, and SEF were recorded before the induction of anesthesia, 5 minutes after induction of anesthesia, 5, 30, and 60 minutes after incision, and at the end of surgery. The incidence, duration, and maximum BSR of intraoperative BS, as well as the incidence of POD 1, 2, and 3 days after surgery were recorded.
Results: There was no significant difference in AUTMAP values between the two groups. Compared with single parameter group, intraoperative propofol and remifentanil dosage were significantly decreased (P < 0.05), awakening time, PACU stay, and postoperative hospitalization time were significantly shorter in multiparameter group (P < 0.05), the PSI was significantly increased 5, 30, and 60 minutes after incision and at the end of surgery, and the SEF was significantly increased 5 minutes after induction of anesthesia, 5, 30, and 60 minutes after induction and the end of surgery (P < 0.05). Compared with single parameter group, incidence of intraoperative BS was significantly decreased, duration of BS was significantly shorter, smaller maximum BSR was significantly decreased, and incidence of POD on 1 day after surgery in multiparameter group (P < 0.05).
Conclusion: Anesthesia management guided by multiparameter EEG can inhibit the occurrence of BS, mitigate the degree of BS, and reduce the incidence of POD in elderly patients undergoing abdominal surgery. |
