[The correlation between burst suppression on electroencephalogram during laparoscopic surgery and emergence delirium in elderly patients].

Objective: To investigate the relationship between intraoperative electroencephalogram burst suppression (BS) and emergence delirium (ED) in elderly patients undergoing elective laparoscopic surgery under total intravenous anesthesia (TIVA). Methods: From October 2017 to September 2019, a total of 358 elderly patients who underwent elective laparoscopic surgery under TIVA at Xiangya Hospital, Central South University, were included. Patients were divided into two groups based on the confusion assessment method for the intensive care unit (CAM-ICU) assessment conducted before leaving the post-anesthesia care unit (PACU): the ED group [n=63, 46 males, 17 females, average age of (70.8±0.6) years] and the non-ED group [n=295, 220 males, 75 females, average age of (69.7±0.2) years]. Preoperative general information, intraoperative conditions, and intraoperative electroencephalogram BS status were collected. A multivariate logistic regression model was employed to identify risk factors associated with ED. Results: In the ED group, the duration of surgery, intraoperative blood loss, the burst suppression ratio (BSR)>10% lasting for more than 1 minute were (224.4±9.6) min, (240.8±33.9) ml, 36.5% (23/63), respectively, which were higher than those of the non-ED group [(204.7±3.6) min, (150.5±9.2) ml, 21.7% (64/295), all P<0.05]. Multivariate logistic regression analysis revealed that a longer duration of education was a protective factor for ED (OR=0.904, 95%CI: 0.833-0.982,P=0.016), whereas increased intraoperative blood loss (OR=1.002, 95%CI: 1.000-1.003, P=0.013) and BSR>10% lasting for more than 1 minute (OR=2.131, 95%CI: 1.004-4.524,P=0.049) were identified as risk factors for ED. Conclusion: In elderly patients undergoing laparoscopic surgery under TIVA, intraoperative electroencephalogram BS may be a risk factor for ED.目的： 探讨老年患者全凭静脉麻醉下择期腹腔镜术中脑电爆发抑制与苏醒期谵妄（ED）的相关性。 方法： 回顾性收集中南大学湘雅医院2017年10月至2019年9月行全凭静脉麻醉下择期腹腔镜手术治疗的老年患者358例。根据患者出麻醉后恢复室（PACU）前重症监护室意识模糊评估量表（CAM-ICU）结果将患者分为ED组［63例，男46例，女17例，年龄（70.8±0.6）岁］及非ED组［295例，男220例，女75例，年龄（69.7±0.2）岁］。采集患者术前一般情况、术中相关情况、术中脑电爆发抑制情况，采用多因素logistic回归模型分析患者发生ED的危险因素。 结果： ED组患者手术时间、术中失血量、术中脑电爆发抑制比（BSR）>10% 且持续1 min以上发生率分别为（224.4±9.6）min、（240.8±33.9）ml、36.5%（23/63），均高于非ED组的（204.7±3.6）min、（150.5±9.2）ml、21.7%（64/295）（均P<0.05）。多因素logistic回归分析显示，受教育年限长是ED的保护因素（OR=0.904，95%CI：0.833~0.982，P=0.016），术中失血量多（OR=1.002，95%CI：1.000~1.003，P=0.013）、BSR>10%且持续1 min以上（OR=2.131，95%CI：1.004~4.524，P=0.049）是ED的危险因素。 结论： 老年患者腹腔镜术中脑电爆发抑制可能是手术后ED的危险因素。.