术前轻度认知功能障碍对老年女性患者七氟烷抑制切皮时体动反应效力的影响  

Effect of preoperative mild cognitive impairment on potency of sevoflurane in inhibiting body movement responses during skin incision in aged female patients

作　　者：王磊 牛志强[1] 杨森[1] 郭玉峰 刘敏 Wang Lei;Niu Zhiqiang;Yang Sen;Guo Yufeng;Liu Min(Department of Anesthesiology,Cangzhou Central Hospital,Cangzhou 061001,China)

机构地区：[1]沧州市中心医院麻醉科,沧州061001

出　　处：《中华麻醉学杂志》2024年第8期977-980,共4页Chinese Journal of Anesthesiology

基　　金：沧州市重点研发计划指导项目(213106084)。

摘　　要：目的评价术前轻度认知功能障碍对老年女性患者七氟烷抑制切皮时体动反应效力的影响。方法本研究为前瞻性研究。选取2022年1月至2023年3月拟行乳腺癌根治术女性患者,年龄60~75岁,BMI 18.5~23.9 kg/m^(2),ASA分级Ⅰ或Ⅱ级。采用简易智能状态检查量表和蒙特利尔认知评估量表进行评估,按照是否存在术前轻度认知功能障碍分为2组:正常组(N组)和轻度认知功能障碍组(M组)。患者均吸入8%七氟烷全麻诱导,待患者意识消失,下颌松弛后置入喉罩,采用Dixon序贯法首例患者呼气末七氟烷浓度设定为2%,若发生体动反应,升高一个浓度梯度,否则降低一个浓度梯度,浓度梯度为0.2%。采用概率单位法计算七氟烷最低肺泡有效浓度(MAC)及其95%可信区间(CI)。结果N组七氟烷MAC为1.60%(95%CI 1.48%~1.70%),M组七氟烷MAC为1.38%(95%CI 1.25%~1.49%),差异有统计学意义(P<0.05)。结论术前轻度认知功能障碍可增加七氟烷抑制老年女性患者切皮时体动反应的效力。ObjectiveTo evaluate the effect of preoperative mild cognitive impairment(MCI)on the potency of sevoflurane in inhibiting body movement responses during skin incision in aged female patients.MethodsThis was a prospective study.Female American Society of Anesthesiologists Physical Status classificationⅠorⅡpatients,aged 60-75 yr,with body mass index of 18.5-23.9 kg/m^(2),scheduled to undergo radical mastectomy between January 2022 and March 2023 in our hospital,were selected.The patient′s cognitive function was assessed using Mini-Mental State Examination and Montreal Cognitive Assessment.The patients were divided into 2 groups based on whether they had MCI or not before operation:normal group(group N)and MCI group(group M).General anesthesia was induced by inhaling 8%sevoflurane,and the laryngeal mask airway was inserted after they lost consciousness and their jaws relaxed.According to the Dixon′s up-and-down method,the end-tidal concentration of sevoflurane in the first patient was set at 2%.If the body movement response occurred,the concentration was increased by 2%in the next patient,otherwise the concentration was decreased by 2%in the next patient.The MAC and 95%confidence interval(CI)of sevoflurane were calculated using the probability regression method.ResultsThe minimum alveolar concentration of sevoflurane was 1.60%(95%CI 1.48%-1.70%)in group N and 1.38%(95%CI 1.25%-1.49%)in group M,and there was statistically significant difference(P<0.05).ConclusionsPreoperative MCI can increase the potency of sevoflurane in inhibiting body movement responses during skin incision in aged female patients.

关 键 词：七氟烷 剂量效应关系 药物 认知功能障碍 老年人 女性 

分 类 号：R614[医药卫生—麻醉学]