全麻患者麻醉恢复期躁动与术后认知功能障碍的关系  

Relationship between emergence agitation during recovery from general anesthesia and postoperative cognitive dysfunction

作　　者：陈易[1] 魏昌伟[1] 俞一瑾[1] 倪新莉[1] 熊利泽[2] 

机构地区：[1]宁夏医科大学总医院麻醉科,银川市750004 [2]第四军医大学西京医院麻醉科

出　　处：《中华麻醉学杂志》2013年第1期34-36,共3页Chinese Journal of Anesthesiology

基　　金：宁夏回族自治区科技攻关计划宁陕合作项目（2012年）

摘　　要：目的评价全麻患者麻醉恢复期躁动与术后认知功能障碍（POCD）的关系。方法择期全麻手术患者280例，性别不限，年龄18～70岁，体重52～80kg，ASA分级Ⅰ或Ⅱ级。于拔除气管导管后15。40min时采用术后恢复质量评估量表评估麻醉恢复期躁动的发生情况，于术前1d、术后1—7d评估认知功能。根据是否出现POCD将患者分为POCD组和非POCD组。记录患者一般情况、术前合并症及手术类型，将组间差异有统计学意义的因素进行多因素logistic回归分析。结果术后POCD发生率40．7％。logistic回归分析结果显示：与POCD发生明显相关因素的危险程度从高至低：麻醉恢复期躁动、麻醉时间、年龄。结论全麻患者麻醉恢复期躁动是POCD发生的独立危险因素之一。Objective To evaluate the relationship between emergence agitation （EA） during recovery from general anesthesia and postoperative cognitive dysfunction （POCD）. Methods Two hundred and eighty ASA I or II patients, aged 18-70 yr, weighing 52-80 kg, undergoing elective surgery, were included. Anesthesia was induced with midazolam, fentanyl, propofol and cisatraeurium. The patients were trachea/intubated and mechanically ventilated. Anesthesia was maintained with remifentanil, propofol and cisatraeurium. EA was assessed at 15- 40 min after extubation by using Post-operative Quality Recovery Scale and the cognitive function was assessed at day 1 before operation and days 1-7 after operation. Patients were divided into POCD or nonPOCD group according to the occurrence of POCD. The general data of patients, preoperative complications and types of surgery were recorded. If there was significant difference between the 2 groups, the factor was analyzed using multi-factor logistic regression to select the risk factor for incidence of POCD. Results The incidence of POCD was 40.7 % . The results of logistic regression analysis showed that the dangerous degree of the risk factors for POCD in order from high to low were emergence agitation, duration of anesthesia and age. Conclusion EA during recovery from general anesthesia is an independent risk factor for POCD.

关 键 词：精神运动性激动 麻醉恢复期 认知障碍 手术后并发症 

分 类 号：R614[医药卫生—麻醉学]