The Impact of Anesthetic Management Under Bispectral Index Monitoring on the Early Recovery Quality of Elderly Patients Undergoing Laparoscopic Surgery: A Blinded Randomized Controlled Trial.
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引用次数: 0
Abstract
Purpose: To comprehensively evaluate the impact of bispectral index (BIS) monitoring-guided anesthesia depth on the early recovery quality in elderly patients undergoing laparoscopic surgery.
Methods: Ninety patients aged ≥60 years scheduled for laparoscopic surgery under general anesthesia were randomized into three groups: Group C (empirically guided anesthesia), Group B1 (BIS-guided, target range 40-60), and Group B2 (BIS-guided, target range 50-60). Blinded researchers evaluated recovery quality (QoR-15), pain (VAS), and sleep (RCSQ) preoperatively and on postoperative days 1, 2, 3, and 7 (POD1,2,3,7). Postoperative delirium was assessed with CAM (POD1-POD3), and cognitive function (MMSE) was measured preoperatively, POD3, and POD7. Intraoperative data included vital signs, BIS values, anesthetic dosage, emergence/extubation times, PACU stay, and adverse events within three days post-surgery. Time to first ambulation and hospital stay were also recorded.
Results: Compared with Group C, Group B1 and B2 had lower propofol consumption, shorter emergence/extubation times, and higher BIS values (T2-T5 and overall mean) (P<0.05). QoR-15 scores improved on POD2 in Group B1 and on both POD1 and POD2 in Group B2 (P<0.05). The RCSQ scores increased on POD1 and POD3 in Group B1 (P<0.05) and on POD1, POD2 and POD3 in Group B2 (P<0.05). In addition, Group B2 had a shorter PACU stay and time to first postoperative ambulation (P<0.05). No differences were found in the incidence of postoperative delirium, POCD, or MMSE scores among the three groups. Compared to Group B1, Group B2 exhibited shorter emergence and extubation times, elevated BIS values at T3 and T5, a higher mean BIS value throughout surgery, and enhanced QoR-15 scores on POD1 and POD2 (P<0.05).
Conclusion: BIS monitoring-guided anesthesia management can enhance early recovery from laparoscopic surgery in elderly patients with BIS values within a safe range, which may be particularly advantageous for this demographic during laparoscopic procedures.
期刊介绍：
Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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