氟马西尼对丙泊酚麻醉后认知功能的影响

Effects of flumazenil on postoperative cognitive function in patients anesthetized with propofol

目的研究氟马西尼对丙泊酚麻醉下经腹腔镜行子宫手术患者认知功能的影响。方法将50例45-55岁经腹腔镜行子宫手术的女性患者（ASAⅠ-Ⅱ级）,随机分为氟马西尼组（F组）和对照组（C组）。术中采用以丙泊酚为主的全凭静脉麻醉。术毕待4个成串刺激出现4个后分别给予氟马西尼0.3 mg或生理盐水3 mL,拔管后观察2 h。测定术前1 d,给药后30min2、h和24 h空间表象效率、单词再忆能力、简单计算能力和图片再认能力的变化。结果两组患者术后认知功能均有不同程度的下降,24 h后逐渐恢复,给予氟马西尼后30 min、2 h患者空间认知能力、单词再忆能力、简单计算能力和图片再认能力均有一定程度的改善,与对照组比较差异有统计学意义（P〈0.05）。结论丙泊酚全身麻醉下经腹腔镜行子宫手术术后早期患者的认知功能有所降低,给予氟马西尼后,可改善患者认知功能降低。

Objective To investigate the effects of flumazenil on postoperative cognitive recovery in the patients who underwent operation on uterus anesthetized with propofol.Methods Fifty ASA ⅠorⅡ female patients aged 45-55 years,underwent operation on uterus were divided into two groups：group received flumazenil（group F） and control group（group C）.Anesthesia was maintained with propofol,vecuronium and remifentail.0.3 mg flumazenil or 3 mL NS were infused after operation when four twitches of train-of-four appeared respectively.All patients were stayed for 120 min.Four cognitive（revolved Chinese character test,word recall test,picture recall test and calculate ability test） tests were performed for all patients at 1d before operation,30 min,2 h and 24 h after operation.Results Cognitive function of the patient anesthetized with propofol was impaired after operation on uterus,and recovered at 24 h after operation.Cognitive function of the patients treated with flumazenil at 30 min,2 h after infusion was improved compared with group C.Conclusion Cognitive function of patients anesthetized with propofol is impaired,flumazenil treatment may improve cognitive function after propofol anesthesia.