基于“康复前移”理念麻醉中引入经颅磁刺激治疗在降低老年患者术后躁动的临床研究

Clinical Study on Applying Transcranial Magnetic Stimulation Therapy during Anesthesia under the Concept of “Early Rehabilitation” to Reduce Postoperative Agitation in Elderly Patients

摘要: 目的：研究基于“康复前移”理念麻醉中引入经颅磁刺激治疗在降低老年患者麻醉术后躁动中的应用效果。方法：选取2024年10月至2025年2月期间在本院接受气管插管或喉罩通气全身麻醉的择期手术老年患者100例作为研究对象，采取数字随机表法将患者分成对照组和研究组，每组患者50例。对照组采取常规全身麻醉方案，研究组在此基础上采取经颅磁刺激治疗，比较两组患者术后躁动发生情况。结果：研究组患者术后各个时间段VAS评分明显低于对照组患者，P < 0.05；Steward苏醒评分术后各个时间段均显著高于对照组患者，P < 0.05；研究组患者术后各个时间段发生术后躁动的概率较低，P < 0.05。结论：基于“康复前移”理念麻醉中引入经颅磁刺激治疗，能够降低老年患者麻醉术后躁动发生概率，同时能够减轻患者术后的疼痛感，有较高的安全性，适合在老年患者麻醉手术中推广应用。

Abstract: Objective: To explore the clinical efficacy of introducing transcranial magnetic stimulation (TMS) therapy during anesthesia guided by the concept of “early rehabilitation”, for the reduction of postoperative agitation in elderly patients receiving general anesthesia. Methods: A total of 100 elderly patients scheduled for elective surgery under general anesthesia (with tracheal intubation or laryngeal mask airway ventilation) admitted to our hospital from October 2024 to February 2025 were enrolled. Subjects were allocated into a control group and a study group (50 cases per group) via the random number table method. The control group received conventional general anesthesia regimens; the study group was administered additional transcranial magnetic stimulation therapy based on the routine anesthesia plan. The incidence of postoperative agitation was compared between the two groups. Results: Postoperative Visual Analogue Scale (VAS) scores at all time points were significantly lower in the study group than in the control group (P < 0.05); Steward recovery scores at each postoperative interval were notably higher in the study group (P < 0.05). The incidence of postoperative agitation across all postoperative time periods was significantly decreased in the study group (P < 0.05). Conclusion: Peri-anesthetic transcranial magnetic stimulation guided by the “early rehabilitation” concept can lower the risk of postoperative agitation and relieve postoperative pain in elderly patients. This intervention features satisfactory safety and deserves wide popularization and application in anesthetic management for elderly surgical patients.