期刊文献+

麻醉对术后患者认知功能影响的探讨 被引量:6

Effect of General Anesthesia on Postoperative Cognitive Function
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摘要 目的:比较丙泊酚复合瑞芬太尼静脉麻醉(TIA)与七氟醚复合笑气吸入麻醉(SNA)对鼻内镜患者术后认知功能障碍(P0CD)的响。方法:ASA Ⅰ~Ⅱ级择期行鼻内镜手术患者48例随机分两组:TIA组24例;SNA组24例。手术期间脑电双频指数(BIS)维持在40~5间。于术前及术后1、3、24h应用简易智能状态测试法(MMES)评定病人认知功能,比较两组患者手术后麻醉恢复情况及并发症。结①TIA组术后1h及SNA组术后1h、3h MMES评分与术前比较和两组术后1h、3hMMES评分组间比较差异有统计学意义(P<0.05)。术后24组病人MMES评分均恢复至术前水平。②TIA组自主呼吸恢复时间、意识恢复时间、定向力恢复时间及拔管时间、术后躁动发生率均少SNA组(P<0.05);TIA组拔管即刻OAA/S评分高于SNA组(P<0.05),③两组病人均无术中知晓发生。结论:两组患者术后均发生短时POCDTIA组患者POCD持续时间较短,且术后恢复苏醒质量要好于SNA组。 Objective: To Compare the effects on postoperative cognitive function for intravenous anesthesia with propofol combined remifentanil and inhalational anesthesia sevenflurane combined nitrous oxide in patients undergoing endoscopic sinus surgery. Methods: Forty-eight ASAⅠ-Ⅱ patients aged 18-70years undergoing endoscopic sinus surgery were randomized assigned to two groups:total intravenous anesthesia(group TIA,n=24)and inhalational anesthesia (group SNA,n=24).The bispectral index (BIS) in operating was adjusted in 40-50. The Mini-Metal State Examination(MMSE)was used to assess cognitive function before and at 1,3, and 24 h after surgery. The recovery profiles and postoperative complications between the two groups were compared.Results: The MMES scores decreased significantly at lh in group TIA and lh, 3h in group SNA after surgery compared with that before surgery in both groups(P〈0.05). There were significant differences in MMES scores between the two groups at lh and 3h after surgery(P〈0.05). The MMES scores returned to preoperative baseline level within 24h after surgery in both two groups. Early recovery times (recovery spontaneous breathing and awareness, orientation, extubation) and the percentage of postoperative dysphoria was significantly shorter in the group TIA than that in the group SNA(P〈0.05). OAA/S scores were significantly higher at extubation in group TIA than that in group SNA(P〈0.05).No intraoperative awareness happened in both groups. Conclusions:Total intravenous anesthesia with propofol combined remifentanil and inhalational anesthesia with sevoflurane combined with 60% nitrous oxide in oxygen may induce temporary postoperative cognitive dysfunction .However the duration of POCD in the group TIA was shorter than that in group SNA, besides the recovery profiles in the group TIA was better than that in group SNA.
出处 《中国医药导刊》 2010年第8期1290-1291,共2页 Chinese Journal of Medicinal Guide
基金 首都医学发展科研基金(编号:2007-1037)
关键词 麻醉 全身 认知功能 手术后 Anesthesia,general Cognitive Function, postoperative
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参考文献5

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二级参考文献11

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