术中脑电图低alpha功率和术后亚谵妄综合征有关

翻译：苗＆丹妮

1

背景

Background

Background： Postoperative delirium （PD） and subsyndromal delirium （PSSD） are frequent complications in older patients associated with poor long－term outcome． It has been suggested that certain electroencephalogram features may be capable of identifying patients at risk during surgery． Thus， the goal of this study was to characterize intraoperative electroencephalographic markers to identify patients prone to develop PD or PSSD．

背景：术后谵妄（PD）和亚谵妄综合征（PSSD）是老年患者常见的并发症，与长期预后较差相关。有人认为，某些脑电图特征可能能够在手术中识别有风险的病人。因此，本研究的目的是描述术中脑电图标记物的特征，以识别有形成PD或PSSD倾向的患者。

2

方法

Methods

Methods： We conducted an exploratory observational study in older patients scheduled for elective major abdominal surgery． Intraoperative 16 channels electroencephalogram was recorded， and PD／PSSD were diagnosed after surgery with the confusion assessment method （CAM）． The total power spectra and relative power of alpha band were calculated．

方法：我们对计划择期进行腹部大手术的老年患者进行了一项探索性观察性研究。术中记录16通道脑电图，术后用意识模糊评估法 （CAM）诊断PD／PSSD。计算了α波段的相对功率和总功率谱。

3

结果

Results

Results： PD was diagnosed in 2 patients （6．7％）， and 11 patients （36．7％） developed PSSD． All of them （13 patients， PD／PSSD group） were compared with patients without any alterations in CAM （17 patients， control group）． There were no detectable power spectrum differences before anesthesia between both groups of patients． However， PD／PSSD group in comparison with control group had a lower intraoperative absolute alpha power during anesthesia （4．4 ± 3．8 dB vs． 9．6 ± 3．2 dB， p ＝ 0．0004） and a lower relative alpha power （0．09 ± 0．06 vs． 0．21 ± 0．08， p ＜ 0．0001）． These differences were independent of the anesthetic dose． Finally， relative alpha power had a good ability to identify patients with CAM alterations in the ROC analysis （area under the curve 0．90 （CI 0．78－1）， p ＜ 0．001）．

结果：发生PD的患者2例 （6．7％），发生PSSD 的患者11例（36．7％）。将这两部分患者（PD／PSSD组共13例）与CAM无任何改变的患者（对照组17例）进行比较。两组患者麻醉前的功率谱无明显差异。然而，PD／PSSD组术中绝对alpha功率低于对照组（4．4±3．8 dB vs． 9．6±3．2 dB， p ＝ 0．0004），相对alpha功率低于对照组（0．09±0．06 vs． 0．21±0．08，p ＜ 0．0001）。这些差异与麻醉剂量无关。最后，相对alpha功率在ROC分析中具有较好的识别CAM改变的患者的能力（曲线下面积0．90 （CI 0．78－1）， p ＜ 0．001）。

4

讨论

Discussion

Discussion： In conclusion， a low intraoperative alpha power is a novel electroencephalogram marker to identify patients who will develop alterations in CAM– i．e．， with PD or PSSD– after surgery．

讨论：总之，术中低alpha功率是一种新的脑电图标记物，用于识别术后CAM（即PD或PSSD）发生改变的患者。

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