PDF(Pubmed)
Abstract：
UNASSIGNED: Cognitive impairment in the elderly may lead to potential increased sensitivity to anesthetic agents targeting receptors associated with cognition. This study aimed to explore the effect of cognitive status on propofol consumption during surgery in elderly patients.
UNASSIGNED: Sixty elderly patients scheduled for laparoscopic radical prostatectomy were allocated to either a cognitively normal [CogN, Montreal Cognitive Assessment (MoCA) score ≥26] or cognitively impaired (CogI, MoCA <26) group. Propofol was administered via target-controlled infusion to maintain a bispectral index (BIS) between 55-65 during surgery. Propofol consumption was recorded at three time points: T1 (abolished eyelash reflex), T2 (BIS = 50), T3 (extubation). BIS values at eyelash reflex abolition were also recorded. Postoperative MoCA, Visual Analogue Scale (VAS) scores, and remifentanil/sufentanil consumption were assessed.
UNASSIGNED: BIS values before induction were similar between CogN and CogI groups. However, at eyelash reflex abolition, BIS was significantly higher in CogI than CogN (mean ± SD: 65.3 ± 7.2 vs. 61.1 ± 6.8, p = 0.031). Propofol requirement to reach BIS 50 was lower in CogI vs. CogN (1.24 ± 0.19 mg/kg vs. 1.46 ± 0.12 mg/kg, p = 0.003). Postoperative MoCA, VAS scores, and remifentanil/sufentanil consumption did not differ significantly between groups.
UNASSIGNED: Compared to cognitively intact elderly, those with cognitive impairment exhibited higher BIS at eyelash reflex abolition and required lower propofol doses to achieve the same BIS level, suggesting increased propofol sensitivity. Cognitive status may impact anesthetic medication requirements in the elderly.
UNASSIGNED: Sixty elderly patients scheduled for laparoscopic radical prostatectomy were allocated to either a cognitively normal [CogN, Montreal Cognitive Assessment (MoCA) score ≥26] or cognitively impaired (CogI, MoCA <26) group. Propofol was administered via target-controlled infusion to maintain a bispectral index (BIS) between 55-65 during surgery. Propofol consumption was recorded at three time points: T1 (abolished eyelash reflex), T2 (BIS = 50), T3 (extubation). BIS values at eyelash reflex abolition were also recorded. Postoperative MoCA, Visual Analogue Scale (VAS) scores, and remifentanil/sufentanil consumption were assessed.
UNASSIGNED: BIS values before induction were similar between CogN and CogI groups. However, at eyelash reflex abolition, BIS was significantly higher in CogI than CogN (mean ± SD: 65.3 ± 7.2 vs. 61.1 ± 6.8, p = 0.031). Propofol requirement to reach BIS 50 was lower in CogI vs. CogN (1.24 ± 0.19 mg/kg vs. 1.46 ± 0.12 mg/kg, p = 0.003). Postoperative MoCA, VAS scores, and remifentanil/sufentanil consumption did not differ significantly between groups.
UNASSIGNED: Compared to cognitively intact elderly, those with cognitive impairment exhibited higher BIS at eyelash reflex abolition and required lower propofol doses to achieve the same BIS level, suggesting increased propofol sensitivity. Cognitive status may impact anesthetic medication requirements in the elderly.
摘要：
■老年人的认知障碍可能导致对靶向与认知相关的受体的麻醉剂的潜在敏感性增加。本研究旨在探讨认知状态对老年患者术中丙泊酚用量的影响。
■60名计划进行腹腔镜前列腺癌根治术的老年患者被分配到认知正常[CogN，蒙特利尔认知评估（MoCA）评分≥26]或认知障碍（CogI，MoCA<26)组。丙泊酚通过靶控输注给药，以在手术过程中维持脑电双频指数（BIS）在55-65之间。在三个时间点记录丙泊酚的消耗：T1（消除睫毛反射），T2(BIS=50),T3（拔管）。还记录了睫毛反射消除时的BIS值。术后MoCA,视觉模拟评分（VAS）评分，评估瑞芬太尼/舒芬太尼的消耗量.
■诱导前的BIS值在CogN和CogI组之间相似。然而,在睫毛反射废除时，CogI的BIS明显高于CogN（平均值±SD：65.3±7.2vs.61.1±6.8，p=0.031）。CogI与CogI相比，丙泊酚达到BIS50的需求较低CogN（1.24±0.19mg/kgvs.1.46±0.12mg/kg，p=0.003)。术后MoCA,VAS评分,两组患者的瑞芬太尼/舒芬太尼用量无显著差异.
■与认知完整的老年人相比，认知障碍患者在睫毛反射消除时表现出更高的BIS，并且需要更低的异丙酚剂量才能达到相同的BIS水平，提示异丙酚敏感性增加。认知状态可能会影响老年人的麻醉药物需求。
■60名计划进行腹腔镜前列腺癌根治术的老年患者被分配到认知正常[CogN，蒙特利尔认知评估（MoCA）评分≥26]或认知障碍（CogI，MoCA<26)组。丙泊酚通过靶控输注给药，以在手术过程中维持脑电双频指数（BIS）在55-65之间。在三个时间点记录丙泊酚的消耗：T1（消除睫毛反射），T2(BIS=50),T3（拔管）。还记录了睫毛反射消除时的BIS值。术后MoCA,视觉模拟评分（VAS）评分，评估瑞芬太尼/舒芬太尼的消耗量.
■诱导前的BIS值在CogN和CogI组之间相似。然而,在睫毛反射废除时，CogI的BIS明显高于CogN（平均值±SD：65.3±7.2vs.61.1±6.8，p=0.031）。CogI与CogI相比，丙泊酚达到BIS50的需求较低CogN（1.24±0.19mg/kgvs.1.46±0.12mg/kg，p=0.003)。术后MoCA,VAS评分,两组患者的瑞芬太尼/舒芬太尼用量无显著差异.
■与认知完整的老年人相比，认知障碍患者在睫毛反射消除时表现出更高的BIS，并且需要更低的异丙酚剂量才能达到相同的BIS水平，提示异丙酚敏感性增加。认知状态可能会影响老年人的麻醉药物需求。
