不同麻醉方法对老年患者术后认知功能的影响  

Effects of Different Anesthesia Methods on Postoperative Cognitive Function in Elderly Patients

作　　者：代华锋 

机构地区：[1]柘城县中医院麻醉科,河南柘城476200

出　　处：《实用临床医学（江西）》2014年第3期49-51,共3页Practical Clinical Medicine

摘　　要：目的探讨不同麻醉方法对老年患者术后认知功能的影响。方法将110例拟行手术的老年患者按麻醉方法的不同分为2组:观察组和对照组,每组55例。观察组行硬脊膜外阻滞麻醉,对照组行全身麻醉。观察2组异丙酚、芬太尼使用量、术后疾病恢复时间及术后认知功能障碍发生的情况,并对2组麻醉前及术后6、24和72 h采用简易精神状态量表(MMSE)进行认知功能评分。结果与对照组比较,观察组术后6、24和72 h MMSE得分、异丙酚使用量均明显升高(均P<0.05),芬太尼使用量、术后认知功能障碍发生率均明显降低和术后疾病恢复时间明显缩短(均P<0.05)。结论硬脊膜外阻滞麻醉较全身麻醉对老年患者术后认知功能影响轻,术后认知功能障碍发生率低,且不增加麻醉药量,对老年患者实行硬脊膜外阻滞麻醉是最佳的选择。Objective To investigate the effects of different anesthesia methods on postoperative cognitive function in elderly patients. Methods A total of 110 elderly patients scheduled for surgery were assigned to receive either epidural anaesthesia （observation group,n=55） or general anesthesia （control group,n=55）.The doses of propofol and fentanyl,postoperative recovery time and incidence of postoperative cognitive dysfunction were observed in both groups. Postoperative cognitive function was evaluated using the Mini-Mental State Examination （MMSE） before anesthesia and 6,24 and 72 hours after operation. Results Compared with control group,epidural anaesthesia increased MMSE score and propofol dose, decreased fentanyl dose and incidence of postoperative cognitive dysfunction,and shortened postoperative recovery time 6,24 and 72 hours after operation （P〈0.05）.Conclusion Epidural anaesthesia exerts milder effect and results in lower incidence of postoperative cognitive dysfunction than general anesthesia. Furthermore, epidural anaesthesia does not increase the dose of anaesthetic. Therefore, epidural anaesthesia is the optimal choice for elderly patients.

关 键 词：老年患者 术后认知功能障碍 硬脊膜外阻滞麻醉 全身麻醉 

分 类 号：R614[医药卫生—麻醉学] R619[医药卫生—外科学]