老年患者全麻与硬膜外麻醉下行腰椎手术后认知功能的变化  

Postoperative Cognitive Effects after General Versus Epidural Anesthesia in Elder Patients Undergoing Spinal Surgery

作　　者：杨志萍[1] 郭旋[1] 卢剑美[1] 钱淑雯[1] 嵇承栋[1] 

机构地区：[1]上海市杨浦区中心医院麻醉科,上海200090

出　　处：《医学综述》2013年第14期2686-2688,共3页Medical Recapitulate

摘　　要：目的比较七氟烷全身麻醉和硬膜外麻醉对老年患者行腰椎术后认知功能的影响。方法将65岁以上择期行腰椎手术的美国麻醉医师协会Ⅰ～Ⅱ级的80例患者随机分为全身麻醉组(A组)和连续硬膜外麻醉组(B组)。评估患者术前(T0)和术后1 d(T1)、2 d(T2)、3 d(T3)、7 d(T4)的单词再忆测验、图片再认测验、简单计算能力测验、斯特鲁普色字测验(SCWT)评分。结果两组患者的图片再认、简单计算、SCWT-1评分在术后第1天降低,术后第3天起恢复。单词再忆和SCWT-2评分在术后第3天均明显降低,至术后第7天记忆能力仍未完全恢复。但两组间认知功能评分比较差异无统计学意义。结论老年患者应用七氟烷全身麻醉和连硬外麻醉行腰椎手术后,部分认知功能降低,但两种麻醉方法对老年患者术后第7天的认知功能评分无差别。Objective To compare the effects of general versus epidural sevoflurane anesthesia on postoperative cognitive function after spinal surgery in aged patients.Methods Eighty ASA Ⅰ-Ⅱ patients over 65 years scheduled for spinal surgery were randomly divided into two groups（n = 40 in each group）.Preoperative（T0） and postoperative 1 d（T1）,2 d（T2）,3 d（T3）,7 d（T4） word memory tests and picture recognition test,a simple calculation aptitude test,stroop color word test（SCWT） score of the two groups were assessed.Results The picture recognition,simple calculation,SCWT-1 rated loweron the first day after operation,and recovered after three days.Word memory and SCWT-2 ratings were significantly decreased 3 days after opeartionand the memory capacity was not yet fully recovered till 7 days after operation.Cognitive function scores between the two groups was not significant different.Conclusion General and epidural sevoflurane anesthesia show an impairment of cognitive functions after spinal surgery in a week,but there is no difference in either the magnitude or pattern of change on cognitive tests in a week after spinal surgery.

关 键 词：全身麻醉 硬膜外麻醉 术后认知功能 老年 

分 类 号：R614[医药卫生—麻醉学]