七氟醚与异氟醚对老年病人术后早期认知功能影响的比较  

Effects of Sevoflurane and isoflurane for general anesthesia on the recovery of cognitive function in elderly patients.

作　　者：梁立升[1] 李明川[1] 姜秀良[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院麻醉科,烟台市264000

出　　处：《中华腹部疾病杂志》2006年第12期866-868,共3页Chinese Journal of Celiopathy

摘　　要：目的探究七氟醚与异氟醚对老年病人术后早期认知功能的影响。方法选取ASAⅠ～Ⅱ级择期非心脏手术病人60例，年龄65-88岁，随机分为A、B两组，每组各30例。全麻维持分别吸入3％～5％七氟醚（A组）或1％～3％异氟醚（B组），麻醉深度维持BP波动在基础值的±10％。记录手术后睁眼时间、拔管时间、说话时间等麻醉恢复指标，并于麻醉前、术后1、3、6、24h采用MMS试验评价认知功能。结果两组病人年龄、身高、体重、手术时间、麻醉时间、麻醉药用量均无显性著差异（P〉0．05）。A组病人术后苏醒时间、拔管时间、拔管后说话时间均早于B组（P〈0．05）；术后1h两组MMS评分均明显下降（P〈0．05）。A组病人术后3hMMS评分基本恢复正常。而B组直到术后6h才恢复正常，术后24h所有病人MMS评分均已达术前水平。结论七氟醚与异氟醚均可引起老年病人术后短暂的认知功能障碍，但七氟醚较异氟醚清醒和恢复更快，对老年人术后早期认知功能的影响小于异氟醚。AIM To explore the effects of Sevoflurane and Isoflurane for general anesthesia on the recovery of cognitive function in elderly patients during earlier period after operation. METHODS 60 ASA physical status Ⅰ～Ⅱ consenting elderly patients （6588 years old） were randomly assigned to one of two general anesthetic groups. Follwing inducation of anesthesia, either Sevoflurane 4%-6% （A group） or isoflurane 2% -4% （B group） concentrations were adjusted to maintain comparable depths of hypnosis. Recored time to eye opening, time to extubation, time to verbalization. The mini - mental state （MMS） test was used to assess cognitive function preoperatively and postoperatively at 1,3, 6, 24 h. RESULTS There were no significantly differents in age, sex, height, body weight, duration of anesthesia and surgery.Times to eye opening, extubation,ancl verbalization were markedly shorter for A group. MMS scores were significantly reduced in both groups, and recoveried to the level of preoperative at 3h after operation in A group,but 6h in B group. CONCLUSIONS Both Sevoflurane and isoflurane can result in postoperative cognitive impairment. But Sevoflurane associated with a faster recovery than isoflurane in elderly patients as well as postoperative recovery of cognitive function.

关 键 词：七氟醚 异氟醚 麻醉 全身 认知障碍 

分 类 号：R687[医药卫生—骨科学]