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Objective To investigate the effects of different depths of anesthesia on incidence of postopera-tive cognitive dysfunction (POCD). Methods We systematically retrievedPubmed,OVID,CNKI,CBM and Wanfang database and VIP database for randomized controlled trials(RCTs)from inceptionto December 312016, comparing different depths of anesthesia for their impacts on incidence of early POCD. After data extraction and quality evaluation,Revman 5.3 software was used for statistical data analysis. Results A total of 714 patients in 8 eligible RCTs were identified. Results of meta-analysis were as follows.(1)Incidence of POCD of depth anesthesia (NTS=E0-E1)was lower than general anesthesia(NTS=D0-D1)1 d after surgery(OR=0.21,95%CI 0.13~0.35,P < 0.00001).(2)Incidence of POCD of depth anesthesia(NTS = E1)was lower than general anesthesia (NTS=D0)7 d after surgery(OR=0.45,95%CI 0.23~0.91,P=0.03).(3)Incidence of POCD of NTS=E1 was lower than NTS=D07d after surgery(OR=0.42,95%CI 0.24~0.71,P=0.001). Conclusion Comparedwith general anesthesia,depth anesthesia is associated with a lower incidence of early POCD.
RESUMO
Objective To investigate the effects of different depths of anesthesia on incidence of postopera-tive cognitive dysfunction (POCD). Methods We systematically retrievedPubmed,OVID,CNKI,CBM and Wanfang database and VIP database for randomized controlled trials(RCTs)from inceptionto December 312016, comparing different depths of anesthesia for their impacts on incidence of early POCD. After data extraction and quality evaluation,Revman 5.3 software was used for statistical data analysis. Results A total of 714 patients in 8 eligible RCTs were identified. Results of meta-analysis were as follows.(1)Incidence of POCD of depth anesthesia (NTS=E0-E1)was lower than general anesthesia(NTS=D0-D1)1 d after surgery(OR=0.21,95%CI 0.13~0.35,P < 0.00001).(2)Incidence of POCD of depth anesthesia(NTS = E1)was lower than general anesthesia (NTS=D0)7 d after surgery(OR=0.45,95%CI 0.23~0.91,P=0.03).(3)Incidence of POCD of NTS=E1 was lower than NTS=D07d after surgery(OR=0.42,95%CI 0.24~0.71,P=0.001). Conclusion Comparedwith general anesthesia,depth anesthesia is associated with a lower incidence of early POCD.
RESUMO
Objective To investigate the reliability of Narcotrend for monitoring the depth of sedation [the observer's assessment of alterness/sedation(OAA/S) scale] with midazolam and correlation between the depth of sedation and Narcotrend index.Methods 0 ASA Ⅰ-Ⅱ status patients scheduled for elective lower limb operations underwent spinal anesthesia,who were given target-controlled infusion of midazolam.Target plasma concentration was 50ng/ ml at first and increased by 10 ng/ml each grade until OAA/S scale became 1 point.Each target concentration infusion was maintained for 5min.Observe the patient the OAA/S scale to be 5 points.If the operation was not over yet,regulated the appropriate depth of sedation until the end of operation.The Narcotrend index of different OAA/S scale and heart rate,mean arterial pressure,respiration were recorded.Results In the deepening or recovery phase of sedation,OAA/S scales were correlated with Narcotrend index (Spearman' s r =0.786,0.652,all P ＜ 0.05).Conclusion Narcotrend is a good index to guide target controlled infusion of midazolam,the index is closely related with the depth of sedation of midazolam.