The impact of general anesthesia medication guided by the nociceptive stimulation index (NOX) on perioperative neurocognitive impairment in elderly patients undergoing thoracoscopic lobectomy
伤害性刺激指数（NOX）指导全身麻醉用药对老年胸腔镜肺叶切除术患者围术期神经认知障碍的影响

摘要

目的 观察在对老年胸腔镜肺叶切除术患者术中开展伤害性刺激指数（NOX）指导全身麻醉用药的效果。方法 在广州医科大学附属清远医院2023年10月至2024年3月65 岁以上择期行胸腔镜肺叶切除手术的老年患者中选择66例为研究样本，结合患者在手术过程中是否开展NOX监测划分为2组，即试验组 NOX 组及对照组 BIS 组，NOX 组术中维持 SSI 值在 40-60 之间，NOX 值在 40-60 之间，BIS 组术中维持 BIS 值在 40-60 之间。对两组麻醉药物用量、围术期神经认知障碍情况进行分析。结果 NOX 组及患者术中麻醉药物用量低于BIS 组，P<0.05。围术期神经认知障碍发生率，NOX 组及低于BIS 组，P<0.05。结论 在进行老年胸腔镜肺叶切除术治疗的过程中开展伤害性刺激指数（NOX）指导全身麻醉用药，有助于减少麻醉药物使用量，降低围术期神经认知障碍发生率，有助于患者恢复。

Abstract

Objective To observe the effect of noxious stimulation index (NOx) in guiding the use of general anesthesia in elderly patients undergoing thoracoscopic lobectomy.
Methods from October 2023 to March 2024, 66 elderly patients over 65 years old undergoing thoracoscopic lobectomy in Qingyuan Hospital Affiliated to Guangzhou Medical University were selected as the research samples, and were divided into two groups according to whether the patients carried out NOx monitoring during the operation, namely, the experimental group NOx group and the control group BIS group. The SSI value in the NOx group was maintained between 40-60, the NOx value was maintained between 40-60, and the BIS value in the BIS group was maintained between 40-60. The dosage of anesthetics and perioperative neurocognitive impairment in the two groups were analyzed.
Results the dosage of anesthetic drugs in NOx group and patients during operation was lower than that in BIS group, P<0.05. The incidence of perioperative neurocognitive impairment in NOx group was lower than that in BIS group, P<0.05.
Conclusion   in the process of thoracoscopic lobectomy in the elderly, noxious stimulation index (NOx) is used to guide the use of general anesthesia, which is helpful to reduce the use of narcotic drugs, reduce the incidence of perioperative neurocognitive impairment, and help patients recover.