不同比重布比卡因腰麻对老年患者术后早期认知功能的影响

Influence of different specific gravity Bupivacaine for lumbar anesthesia on early postoperative cognitive function in elder patients

目的:探讨不同比重布比卡因腰麻对老年患者术后早期认知功能的影响。方法:90例年龄≥60岁老年患者随机分为3组:轻比重组30例(A组),腰麻液为0.25%布比卡因5ml;重比重组30例(B组),腰麻液为0.5%布比卡因3ml;等比重组30例(C组),腰麻液为0.25%布比卡因4ml。采用简易智能量表(MMSE)法评估患者术前1天及术后1、3、5天认知功能。术后认知功能障碍(POCD)的诊断是首先计算所有患者麻醉前MMSE评分,患者以麻醉前测试值为对照,等于或超过1个标准差诊断患者出现POCD。结果:3组患者术后第1天MMSE值明显低于术前(P<0.05),A组术后早期发病率为43%;B组术后早期发病率为50%;C组术后早期发病率为40%;3组比较差异无统计学意义(P>0.05)。结论:不同比重布比卡因腰麻对老年患者术后早期认知功能障碍的影响无显著差异。

Objective：To explore the influence of different specific gravity of Bupivacaine for lumbar anes- thesia on early postoperative cognitive function in elderly patients. Methods：90 patients aged more than 60 year old were randomly assigned to 3 groups. Hypobaric group（group A） were given 0.25% hypobaric Bupivacaine 5ml, Hy- perbaric group（group B） were given 0.5% hyperbaric Bupivacaine 3ml, Isobaric group（group C） were given 0.25 isobaric Bupivacaine 4ml. Cognition function of each patient ld before and 1d, 3d, 5d after operation was evaluated by MMSE methed. It was considered to be postoperative cognitive dysfunction （POCD） when the score was ≥1 stand- ard deviation. Results：The score of MMSE on the first day after surgery was lower than the score before surgery（P〈0.05）. There were cases what had acute cognitive dysfunction in group A,and cases in group B, and cases in group C, There were no significant differences between the 3 groups（P〉0.05）. Conclusion： There is no significant influ- ence of different specific gravity of Bupivacaine for lumbar anesthesia on early postoperative cognitive function in eld- erly patients.