比较七氟醚和地氟醚对腹腔镜手术患者术后短期嗅觉记忆的影响及其机制  

Effects of sevoflurane and desflurane on short-term olfactory memory after laparoscopic surgery and its mechanism

作　　者：王子君 苏金华 曹莹 陈婕 潘进喆 周美吾 孙昌宇 高鸿 黄健 Wang Zijun;Su Jinhua;Cao Ying;Chen Jie;Pan Jinzhe;Zhou Meiwu;Sun Changyu;Gao Hong;Huang Jian(Department of Anesthesiology,the Second People's Hospital of Guiyang,Guiyang 550081,China)

机构地区：[1]贵阳市第二人民医院麻醉科,贵阳550081 [2]贵州医科大学附属医院麻醉科,贵阳550001 [3]贵州省第三人民医院麻醉科,贵阳550008

出　　处：《国际麻醉学与复苏杂志》2022年第9期940-943,共4页International Journal of Anesthesiology and Resuscitation

基　　金：贵阳市科技局计划项目(筑科合同[2019]9-9-7号);贵州省卫生健康委科学技术计划项目(gzwkj2021-281)。

摘　　要：目的探讨七氟醚和地氟醚对腹腔镜手术患者术后短期嗅觉记忆的影响及其机制。方法选取贵阳市第二人民医院择期拟行腹腔镜手术的患者76例,性别不限,年龄18~60岁,ASA分级Ⅰ、Ⅱ级,采用随机数字表法分为七氟醚组(S组)和地氟醚组(D组),每组38例。S组和D组患者术中分别吸入1.0 MAC七氟醚和地氟醚维持麻醉,其他用药相同。分别于麻醉前30 min(T_(1))及在PACU当Aldrete评分≥9分时(T_(2)):记录两组患者心率、MAP;采用康涅狄格化学感觉临床研究中心嗅觉功能检查法对患者进行嗅觉记忆测试,记录嗅觉识别分数;ELISA法检测患者血浆S100β蛋白、神经元特异性烯醇化酶(neuron specific enolase,NSE)和褪黑素水平。结果T_(1)、T_(2)时两组患者心率、MAP比较,差异无统计学意义(P>0.05)。T_(1)时,两组患者嗅觉识别分数、S100β蛋白、NSE和褪黑素水平比较差异无统计学意义(P>0.05)。T_(2)时,S组嗅觉识别分数、褪黑素水平低于D组(P<0.05),S100β蛋白和NSE水平高于D组(P<0.05)。与T_(1)时比较,T_(2)时S组嗅觉识别分数、褪黑素水平降低(P<0.05),S100β蛋白和NSE水平升高(P<0.05);D组各指标差异无统计学意义(P>0.05)。结论地氟醚对腹腔镜手术患者的术后短期嗅觉记忆无明显影响,而七氟醚影响了患者术后短期嗅觉记忆,这可能与七氟醚增加血浆S100β蛋白、NSE水平和降低褪黑素水平有关。Objective To observe the effect of sevoflurane and desflurane on short-term olfactory memory in patients after laparoscopic surgery and to explore its mechanism.Methods A total of 76 patients,American Society of Anesthesiologists(ASA)ⅠorⅡ,aged 18-60 years old,who were scheduled for laparoscopic surgery in the Second People's Hospital of Guiyang were enrolled.According to the random number table method,the patients were divided into two groups(n=38):a sevoflurane group(group S)and a desflurane group(group D).During the operation,they individually inhaled with 1.0 minimum alveolar concentration(MAC)sevoflurane or desfluran to maintain anesthesia,other drugs were the same.At 30 min before anesthesia(T_(1))and when Aldrete Recovery Score≥9 in the post-anesthesia care unit(PACU)(T_(2))respectively,heart rate and mean arterial pressure(MAP)of the two groups were recorded;the olfactory memory was evaluated by the Connecticut Chemosensory Clinical Research Center olfactory test,and the score of olfactory recognition was recorded;the levels of plasma S100βprotein,neuron specific enolase(NSE),and melatonin were determined using enzyme-linked immunosorbent assay(ELISA).Results There was no statistical difference in heart rate and MAP at T_(1)and T_(2)between group D and group S(P>0.05).At T_(1),there were no significant differences in the score of olfactory recognition,the levels of S100βprotein,NSE and melatonin between the two groups(P>0.05).At T_(2),the score of olfactory recognition and melatonin in group S were lower than those in group D(P<0.05),and the levels of S100βprotein and NSE in group S were higher than those in group D(P<0.05).Compared with T_(1),at T_(2),the score of olfactory recognition and melatonin in group S were decreased(P<0.05),and the levels of S100βprotein and NSE were increased(P<0.05);there was no significant difference in the indexes of group D(P>0.05).Conclusions Desflurane cannot affect the short-term postoperative olfactory memory of patients undergoing laparoscopic surgery,while se

关 键 词：七氟醚 地氟醚 嗅觉记忆 神经炎症 褪黑素 

分 类 号：R614[医药卫生—麻醉学]