摘要
目的研究比较瑞芬太尼与异氟醚对老年患者全麻术后早期认知功能的影响。方法ASAⅠ～Ⅱ级择期行非心脏手术患者60例,随机分为A、B2组,每组30例。全麻维持分别用0.05～2.0μg(kg·min)瑞芬太尼(A组)或1%～3%异氟醚(B组),麻醉深度维持BP波动在基础值的±10%。记录手术后睁眼时间、拔管时间、语言应答时间等麻醉恢复指标,并于麻醉前,术后1h、3h、6h、24h采用简易智力状态检查(MMSE)评价认知功能。结果2组患者年龄、身高、体重、手术时间、麻醉时间、麻醉药用量均无显著差异(P>0.05);A组患者术后苏醒时间、拔管时间、拔管后语言应答时间均早于B组(P<0.05);术后1h2组MMSE评分较术前均明显下降(P<0.05),A组患者术后3hMMSE评分基本恢复正常,而B组直到术后6h才恢复正常,术后24h所有患者MMSE评分均已达术前水平。结论瑞芬太尼与异氟醚均可引起老年患者术后短暂的认知功能障碍,但瑞芬太尼较异氟醚恢复更快,对老年人术后认知功能阻碍的作用小于异氟醚。
Objective To explore the effects of remifentanil and isoflurane for general anesthesia on the recovery of cognitive function in elderly patients in the early postoperative period. Methods 60 ASA physical status Ⅰ - Ⅱ consenting elderly patients （aged 65 - 88 years） were randomly assigned to two general anesthetic groups. Following induction of anesthesia, rernifentanil 0.05 - 2.0μg/（kg·min） （group A） or isoflurane 1% - 3% （group B） were adjusted to maintain comparable depth of hypnosis. The time for eye opening, extubation and verbalization after operation were recorded. The mini - mental state examination （MMSE） was used to assess cognitive function preoperatively and 1, 3, 6, 24 h after operation. Results No significant differences were found between the two groups in age, sex, height, body weight, duration of anesthesia or surgery. The time for eye opening, extubation, and verbalization were markedly shorter in group A. MMSE scores were significantly reduced in both groups at 1 h after operation, and recovered to the preoperative level at 3 h in group A, but at 6 h in group B. Conclusion Both remifentanil and isoflurane can result in postoperative cognitive dysfunction in elderly patients, though the recovery is faster after the use of remifentanil than that of isoflurane.
出处
《徐州医学院学报》
CAS
2005年第4期294-296,共3页
Acta Academiae Medicinae Xuzhou
关键词
瑞芬太尼
异氟醚
全身麻醉
认知功能障碍
remifentanil
isoflurane
general anesthesia
cognitive dysfunction
