{"title":"双光谱指数监测对脊髓刺激治疗慢性意识障碍疗效的影响","authors":"Xuanling Chen, Xuewei Qin, Yutong Zhuang, Zhengqian Li, Zhenhu Liang, Hua Zhang, Lan Yao, Xiaoli Li, Jianghong He, Xiangyang Guo","doi":"10.2147/TCRM.S478489","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To observe whether maintaining the appropriate depth of anesthesia with Bispectral Index (BIS) can improve the prognosis of Spinal Cord stimulation (SCS) implantation in patients with chronic Disorders of consciousness (DoC).</p><p><strong>Methods: </strong>103 patients with DoC undergoing SCS implantation were reviewed, and 83 patients with DoC were included according to the standard of inclusion and exclusion Criteria. Patients were divided into a BIS group (n =45) and a non-BIS group (n =38) according to whether BIS monitoring was used during the operation. The depth of anesthesia in the BIS group was maintained between 40-60. The anesthesiologist adjusted the depth of anesthesia in the non-BIS group according to clinical experience. Relevant information such as disease course, cause, anesthesia time, and operation time were collected. Preoperative CRS-R<sub>(preoperative)</sub> score, postoperative CRS-R<sub>(24h),</sub> and postoperative CRS-R<sub>(3m)</sub> changes were collected.</p><p><strong>Results: </strong>The CRS-R(3m) score in the BIS group was higher than that in the non-BIS group <sub>(preoperative)</sub>, and the difference was statistically significant (P < 0.05). In CRS-R <sub>(24h)</sub>, the BIS group was higher than the non-BIS group, and the difference was statistically significant (X<sup>2</sup>=8.787, P =0.004). The improvement of consciousness was included in the multivariate Logistic regression analysis model, and it was found that the thalamus was an independent factor affecting the improvement of consciousness (P < 0.05). During follow-up, 1 patient in the BIS group had a decrease in consciousness from MCS<sup>-</sup> to VS/ UWS and 2 patients in the non-BIS group died during follow-up.</p><p><strong>Conclusion: </strong>Patients can be benefit in hearing in CRS-R <sub>(24h)</sub>. We recommend the use of BIS to monitor the depth of anesthesia in patients with DoC to improve patient outcomes.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"20 ","pages":"677-687"},"PeriodicalIF":2.8000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444212/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Impact of Bispectral Index Monitoring on Outcomes in Spinal Cord Stimulation for Chronic Disorders of Consciousness.\",\"authors\":\"Xuanling Chen, Xuewei Qin, Yutong Zhuang, Zhengqian Li, Zhenhu Liang, Hua Zhang, Lan Yao, Xiaoli Li, Jianghong He, Xiangyang Guo\",\"doi\":\"10.2147/TCRM.S478489\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To observe whether maintaining the appropriate depth of anesthesia with Bispectral Index (BIS) can improve the prognosis of Spinal Cord stimulation (SCS) implantation in patients with chronic Disorders of consciousness (DoC).</p><p><strong>Methods: </strong>103 patients with DoC undergoing SCS implantation were reviewed, and 83 patients with DoC were included according to the standard of inclusion and exclusion Criteria. Patients were divided into a BIS group (n =45) and a non-BIS group (n =38) according to whether BIS monitoring was used during the operation. The depth of anesthesia in the BIS group was maintained between 40-60. The anesthesiologist adjusted the depth of anesthesia in the non-BIS group according to clinical experience. Relevant information such as disease course, cause, anesthesia time, and operation time were collected. Preoperative CRS-R<sub>(preoperative)</sub> score, postoperative CRS-R<sub>(24h),</sub> and postoperative CRS-R<sub>(3m)</sub> changes were collected.</p><p><strong>Results: </strong>The CRS-R(3m) score in the BIS group was higher than that in the non-BIS group <sub>(preoperative)</sub>, and the difference was statistically significant (P < 0.05). In CRS-R <sub>(24h)</sub>, the BIS group was higher than the non-BIS group, and the difference was statistically significant (X<sup>2</sup>=8.787, P =0.004). The improvement of consciousness was included in the multivariate Logistic regression analysis model, and it was found that the thalamus was an independent factor affecting the improvement of consciousness (P < 0.05). During follow-up, 1 patient in the BIS group had a decrease in consciousness from MCS<sup>-</sup> to VS/ UWS and 2 patients in the non-BIS group died during follow-up.</p><p><strong>Conclusion: </strong>Patients can be benefit in hearing in CRS-R <sub>(24h)</sub>. We recommend the use of BIS to monitor the depth of anesthesia in patients with DoC to improve patient outcomes.</p>\",\"PeriodicalId\":22977,\"journal\":{\"name\":\"Therapeutics and Clinical Risk Management\",\"volume\":\"20 \",\"pages\":\"677-687\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444212/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutics and Clinical Risk Management\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/TCRM.S478489\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"Pharmacology, Toxicology and Pharmaceutics\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutics and Clinical Risk Management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/TCRM.S478489","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Pharmacology, Toxicology and Pharmaceutics","Score":null,"Total":0}
引用次数: 0
摘要
目的方法:回顾性分析103例接受脊髓刺激术(SCS)的DoC患者,根据纳入和排除标准纳入83例DoC患者。根据手术中是否使用 BIS 监测,将患者分为 BIS 组(n =45)和非 BIS 组(n =38)。BIS 组的麻醉深度保持在 40-60 之间。麻醉师根据临床经验调整非 BIS 组的麻醉深度。收集病程、病因、麻醉时间和手术时间等相关信息。收集术前 CRS-R(术前)评分、术后 CRS-R(24h)和术后 CRS-R(3m)的变化情况:结果:BIS 组的 CRS-R(3m)评分高于非 BIS 组(术前),差异有统计学意义(P < 0.05)。在 CRS-R(24 小时)中,BIS 组高于非 BIS 组,差异有统计学意义(X2=8.787,P=0.004)。意识改善情况被纳入多变量 Logistic 回归分析模型,结果发现丘脑是影响意识改善的独立因素(P < 0.05)。随访期间,BIS组有1名患者的意识从MCS-降至VS/ UWS,非BIS组有2名患者在随访期间死亡:结论:CRS-R(24 小时)可使患者的听力获益。我们建议使用 BIS 监测 DoC 患者的麻醉深度,以改善患者的预后。
The Impact of Bispectral Index Monitoring on Outcomes in Spinal Cord Stimulation for Chronic Disorders of Consciousness.
Objective: To observe whether maintaining the appropriate depth of anesthesia with Bispectral Index (BIS) can improve the prognosis of Spinal Cord stimulation (SCS) implantation in patients with chronic Disorders of consciousness (DoC).
Methods: 103 patients with DoC undergoing SCS implantation were reviewed, and 83 patients with DoC were included according to the standard of inclusion and exclusion Criteria. Patients were divided into a BIS group (n =45) and a non-BIS group (n =38) according to whether BIS monitoring was used during the operation. The depth of anesthesia in the BIS group was maintained between 40-60. The anesthesiologist adjusted the depth of anesthesia in the non-BIS group according to clinical experience. Relevant information such as disease course, cause, anesthesia time, and operation time were collected. Preoperative CRS-R(preoperative) score, postoperative CRS-R(24h), and postoperative CRS-R(3m) changes were collected.
Results: The CRS-R(3m) score in the BIS group was higher than that in the non-BIS group (preoperative), and the difference was statistically significant (P < 0.05). In CRS-R (24h), the BIS group was higher than the non-BIS group, and the difference was statistically significant (X2=8.787, P =0.004). The improvement of consciousness was included in the multivariate Logistic regression analysis model, and it was found that the thalamus was an independent factor affecting the improvement of consciousness (P < 0.05). During follow-up, 1 patient in the BIS group had a decrease in consciousness from MCS- to VS/ UWS and 2 patients in the non-BIS group died during follow-up.
Conclusion: Patients can be benefit in hearing in CRS-R (24h). We recommend the use of BIS to monitor the depth of anesthesia in patients with DoC to improve patient outcomes.
期刊介绍:
Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas.
The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature.
As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication.
The journal does not accept study protocols, animal-based or cell line-based studies.