七氟醚与丙泊酚对老年患者全麻术后认知功能影响的比较  

Impaired Cognitive Function after Sevoflurane Versus Propofol General Anesthesia in Aged Patients

作　　者：毛一群[1] 嵇福海[1] 钟丽敏[1] 姜宏宇[1] 

机构地区：[1]苏州大学附属第一医院麻醉科,江苏苏州215006

出　　处：《中国血液流变学杂志》2011年第1期92-94,共3页Chinese Journal of Hemorheology

摘　　要：目的 比较七氟醚与丙泊酚麻醉对老年患者术后认知功能的影响.方法 选择ASAⅠ～Ⅱ级,无糖尿病、心脑血管疾病且未服用影响神经精神系统功能的药物在苏州大学附属第一医院择期全身麻醉下行人工髋关节置换手术的老年患者（65～80岁）40例,随机分为2组,Ⅰ组（n=20）患者以七氟醚、芬太尼、维库溴铵全麻诱导并维持麻醉;Ⅱ组（n=20）患者以靶控输注丙泊酚、芬太尼、维库溴铵全麻诱导并维持麻醉.术中监测麻醉期间心率、无创血压、脉氧、呼末二氧化碳值、脑电双频指数,并根据以上监测调节麻醉深度;术后镇痛采用病人自控静脉镇痛,镇痛效果采用视觉模拟评分（visual analogue scale,VAS）评估.术前、术后1d、7d简易智力状态检查（mini-mental state examination,MMSE）评分.结果 两组患者一般资料、麻醉时间及术后镇痛效果之间差异均无显著性（P〉0.05）;两组患者术后1d及7d与术前比较简易智力状态检查评分差异无显著性（P〉0.05）.结论 七氟醚与丙泊酚麻醉对老年患者术后认知功能的影响无显著差异.Objective To compare the influence of sevoflurane and propofol on the cognitive function in aged patients. Methods 40 ASA Ⅰ～Ⅱaged patients（65 - 80 years old）without diabetes mellitus,scheduled for elective artificial hip replacement surgery in the First Affiliated Hospital of Soochow University, were selected.All of the patients have no cardiac or neuropsychiatric diseases or history of taking corresponding medicines.The patients were randomized sevoflurane（group Ⅰ ） and propofol（group Ⅱ） subgroups（n=20 in each group）.Anesthesia of group I was induced and maintained with sevoflurane,fentanyl,vecuronium,the other group received targetcontrolled infusion with propofol,fentanyl,vecuronium.The parameters（heart rate,noninvasive blood pressure,pulse oximetry, end-tidal CO2,Bispectral Index）were recorded,and the anesthesia was modulated by these parameters. MMSE was performed before anesthesia and 1 day,7 day after operation.Patient-controlled intravenous analgesia device was used after operation,and the patients were evaluated with VAS. Results There were no significant differences between the two groups in age,height,weight,sex ratio and the duration of anesthesia,as well as the postoperative analgesia effect（P〉0.05）.No significant difference was found in MMSE scores between the two groups on the preoperative and postoperative day 1 or 3（P〉0.05）. Conclusion The influence of sevoflurane and propofol on the cognitive function in aged patients has no difference.

关 键 词：七氟醚 丙泊酚 全身麻醉 认知障碍 

分 类 号：R614.2[医药卫生—麻醉学]