不同呼气末七氟醚浓度对老年患者术后认知功能的影响  

Influence of Different End-tidal Concentration of Sevoflurane on Cognitive Function in Elderly Patients after Surgery

作　　者：路璐[1] 曾征兵[1] 张振华[1] 周华[1] 

机构地区：[1]湖南怀化市第一人民医院麻醉科,湖南怀化418000

出　　处：《医学临床研究》2011年第11期2132-2134,共3页Journal of Clinical Research

摘　　要：【目的】探讨不同呼气末七氟醚的浓度对老年患者术后认知功能的影响。【方法】选取择期行腹部手术的ASAⅠ～Ⅲ级老年患者80例，随机分为A、B、C、D四组，每组20人，全身麻醉诱导后给予七氟醚吸入，调节吸入浓度使四组患者呼气末浓度分别为0．7（A组）、1．0（B组）、1．3（C组）、1．6肺泡气最低有效浓度（MAC）（D组）。同时复合微量泵输注异丙酚、维库溴铵维持麻醉，监测麻醉期间心率、平均动脉压（MAP）、术中输姨量，记录手术时间、麻醉时间；于麻醉前和手术后1d、3d、7d分别行简易智力状态检查（MMSE）评分。【结果】术后1d、3dMMSE评分均较术前降低（P〈0．05）同时随着呼气末七氟醚浓度增加，MAP逐渐降低，MMSE评分也逐渐降低。术后7d与术前比较无明显差异（P〉O．05）。【结论】早期呼气末七氟醚浓度的增加对老年患者认知功能的影响也增加，并不产生长期损害。[Objective]To explore the influence of different end-tidal concentration of sevoflurane on cognitive function in elderly patients. [Methods] Totally 80 elderly patients undergoing selective abdominal surgery （ASAI-III） were randomly assigned to group A, B, C and D with 20 cases in each group. Sevoflurane was inhaled after general anesthesia induction. The inhaled concentration was adjusted to make the end-tidal concentration with 0.7（A）, 1.0（B）, 1.3（C） and 1.6 minimum alveolar concentration（MAC） （D） of patients in four groups, respectivelY, Propofol and veeuronium bromide by micro-pump injection was combined simultaneously to maintain anesthesia. Heart rate, mean arterial pressure（MAP） and intraoperative infusion volume were monitored during anesthesia. The operation time and anesthesia time were recorded. The mini-mental state examination（MMSE） was used to assess cognitive function before and at ld, 3d and 7d after surgery. [Results]There were no significant differences in age, weight, gender, operation time, anesthesia time and infusion volume among 4 groups（ P 〉0.05）, but it had comparability. At ld and 3d after surgery, MMSE decreased as compared with before surgery（ P 〈0.05）. Meanwhile, MAP and MMSE scores gradually reduced with the increasing of end-tidal concentration of sevoflurane. No significant differences were found in MMSE between 7d after surgery and before surgery. [Conclusion] The influence of sevoflurane on cognitive function in elderly patients increases with the increasing of early end-tidal concentration of sevoflurane, but it can not cause long-term damage.

关 键 词：认知障碍 醚类/投药和剂量 

分 类 号：R614.21[医药卫生—麻醉学]