盐酸戊乙奎醚对老年患者非心脏手术后早期认知功能的影响

Effect of penehyclidine hydrochloride on cognitive dysfunction early after non-cardiac surgery in elderly patients

目的观察术前应用盐酸戊乙奎醚0.02mg/kg对老年患者全麻下非心脏手术后早期认知功能的影响。方法选择全麻下行择期非心脏手术且年龄>65岁的老年患者60例,随机分为盐酸戊乙奎醚组和对照组。盐酸戊乙奎醚组在麻醉诱导前10min静脉注射盐酸戊乙奎醚0.02mg/kg;对照组则给等容积生理盐水。麻醉诱导后持续微量泵注射丙泊酚及瑞芬太尼、间断注射阿曲库铵维持麻醉。分别在麻醉前和麻醉后3d采用简易智力量表进行神经心理学评估。结果因各种原因,仅有41例患者完成全部测试,其中盐酸戊乙奎醚组20例,对照组21例。盐酸戊乙奎醚组术后认知功能障碍(POCD)发生率为35.0%,对照组为38.1%,两组间差异无统计学意义。结论术前静脉注射0.02mg/kg盐酸戊乙奎醚对老年患者非心脏手术POCD发生率无显著影响。

Objective To observe the effect of penehyclidine hydrochloride on cognitive dysfunction early after non-cardiac surgery in elderly patient under general anesthesia Methods Sixty patients older than 65 years and scheduled for selective non-cardiac surgery were randomly divided into two groups： penehyclidine hydrochloride group and control group. The former were given 0. 02 mg/kg penehyclidine hydrochloride 10 rain before induction, and the latter were given the same-volume saline instead. Anesthesia was maintained with remifentanil and propofol intravenous injection continually and supplemented with intermittent iv injection of atracuciulrL All patients were tested with milbmental state examination, preoperatively and 3d postoperatively. Results A total of 41 patients completed tests;they were 20 patients in penehyclidine hydrochloride group and 21 patients in control group. The incidence of postoperative cognitive dysfunction in penehyclidine hydrochloride group and control group was 35. 0% and 38. 1%, respectively, however there was no significant difference between the two groups. Conclusion Preoperative administration of penehyclidine hydrochloride （0. 02 mg/kg） would not influence the incidence of cognitive dysfunction early after non-cardiac surgery in elderly patients.