Evaluation of BIS guided anesthesia depth management in improving postoperative delirium in elderly patients undergoing orthopaedic surgery
BIS指导麻醉深度管理对改善老年骨科手术患者术后谵妄的作用评价

摘要

目的 分析老年患者骨科手术中采取脑电双频指数（BIS）指导麻醉深度管理的价值。方法 选取100例老年患者，均实施BIS指导麻醉深度管理，随机分对照组（深麻醉）、观察组（浅麻醉），比较效果。结果 麻醉后，观察组感觉阻滞起效时间（9.02±1.95）min、感觉阻滞维持时间（210.78±28.39）min、镇痛维持时间（182.22±31.07）min与对照组的感觉阻滞起效时间（9.87±2.36）min、感觉阻滞维持时间（210.42±25.36）min、镇痛维持时间（189.46±33.54）min比较，差异无统计学意义（t=1963、0.067、1.120，P＞0.05）；观察组患者不同时间点患者血流动力学变化优于对照组，差异有统计学意义P＜0.05；观察组不良反应发生率2.00%、术后谵妄发生率0.00%低于对照组不良反应发生率16.00%、术后谵妄发生率24.00%，差异有统计学意义（χ2=4.396、13.636，P＜0.05）；观察组麻醉苏醒时间（7.51±3.22）min、自主排尿时间（19.33±3.28）h少于对照组麻醉苏醒时间（10.56±5.94）min、自主排尿时间（27.15±4.69）h，差异有统计学意义（t=3.192、7.484，P＜0.05）。结论 老年患者进行骨科手术时，采取BIS指导麻醉深度管理效果显著，能够保障患者血流动力学处于稳定状态，避免术后出现谵妄。

Abstract

Objective: To analyze the value of using bispectral index (BIS) to guide anesthesia depth management in elderly patients undergoing orthopedic surgery. Method: 100 elderly patients were selected and underwent BIS guided deep anesthesia management. They were randomly divided into a control group (deep anesthesia) and an observation group (shallow anesthesia) to compare the effectiveness. Result: After anesthesia, there was no statistically significant difference in the onset time of sensory block (9.02 ± 1.95) minutes, duration time of sensory block (210.78 ± 28.39) minutes, and duration time of analgesia (182.22 ± 31.07) minutes between the observation group and the control group (9.87 ± 2.36) minutes, duration time of sensory block (210.42 ± 25.36) minutes, and duration time of analgesia (189.46 ± 33.54) minutes (t=1963, 0.067, 1.120, P>0.05); The hemodynamic changes of patients in the observation group at different time points were better than those in the control group, and the difference was statistically significant (P<0.05); The incidence of adverse reactions in the observation group was 2.00%, and the incidence of postoperative delirium was 0.00%, which was lower than the incidence of adverse reactions in the control group, which was 16.00%. The incidence of postoperative delirium was 24.00%, and the difference was statistically significant (χ2=4.396, 13.636, P<0.05); The observation group had shorter anesthesia recovery time (7.51 ± 3.22) minutes and autonomous urination time (19.33 ± 3.28) hours compared to the control group (10.56 ± 5.94) minutes and autonomous urination time (27.15 ± 4.69) hours, with statistically significant differences (t=3.192, 7.484, P<0.05)。
Conclusion  : When elderly patients undergo orthopedic surgery, adopting BIS guidance for deep anesthesia management has a significant effect, which can ensure that the patient's hemodynamics are in a stable state and avoid postoperative delirium.