静脉快通道麻醉对老年患者乳腺癌改良根治术后认知功能的影响

Effect of intravenous fast-track anesthesia on postoperative congnitive function in elderly patients after modified radical mastectomy

目的:观察静脉快通道麻醉对老年患者乳腺癌改良根治术后认知功能的影响。方法:择期行乳腺癌改良根治手术的老年女性患者50例,ASA:I～II级,随机等分成2组。T组采用静脉快通道麻醉,I组采用吸入麻醉。两组患者分别于麻醉前及术后1、6、12、24、48 h评估MMSE评分,记录麻醉恢复时间。结果:两组患者年龄、体质量、手术麻醉时间及出入液量差异无统计学意义(P>0.05);两组患者术中心率和血压比较差异无统计学意义(P>0.05);患者术后苏醒、拔管时间I组均长于T组(P<0.05)。两组患者麻醉前MMSE评分差异无统计学意义(P>0.05)。与麻醉前比较,T组患者术后早期(1 h)MMSE评分显著降低(P<0.05);I组患者术后较术前及T组各时间点(1、6、12 h)MMSE评分显著降低(P<0.05)。结论:静脉快通道麻醉术后恢复质量高,术后认知功能影响轻且持续时间短,更适宜老年患者乳腺癌改良根治术。

Objective：To investigate the effect of intravenous fast - track anesthesia on postoperative cognitive function in elderly patients after modified radical mastectomy. Methods： Fifty elderly female patients underwent modified radical mastectomy,ASA：Ⅰ - Ⅱ,were randomly divided into two groups ,intravenous fast-track anesthe-sia（ group T）and inhalation anesthesia（ group I）. Awaking and extubation time after operation were recorded. The mini-mental state examination（MMSE） was used to assess preoperative and postoperative cognitive function after the operation 1,6,12,24,48 h. Results：There were no significant differences between the two groups in age, body weight, volume of infusion and duration of anesthesia and surgery （ P 〉 0.05 ）. Awaking and extubation time after operation in the group T was shorter than those in group Ⅰ. Compared with preoperation, the MMSE scores were sig-nificantly lower（P 〈 0.05 ） in the group T and Ⅰ at 1 h; but in comparison with group Ⅰ ,the MMSE scores at 1,6, 12,24 h of group T were increased significantly（ P 〈 0. 05 ）. Conclusion：Intravenous fast -track anesthesia in eld-erly patients after modified radical mastectomy could get a rapid recovery and reduce the incidence of POCD.