丙泊酚联合利多卡因对老年患者全麻后智力的影响

Effects of propofol combined with lidocaine on intelligence of elderly patients after general anesthesia

目的探讨丙泊酚联合利多卡因对老年患者全身麻醉后智力的影响。方法选择择期腹部手术治疗老年患者80例,随机分为治疗组与对照组各40例。两组都给予丙泊酚辅助全麻,在此基础上,治疗组采用丙泊酚联合利多卡因辅助全身麻醉,观察与记录两组的麻醉效果、生命体征变化与不良反应发生情况。结果两组麻醉与手术均顺利,两组的手术时间、麻醉时间、术中出血量、术后睁眼时间、拔管时间及术后应答时间无统计学差异(P>0.05)。两组在不同时间点的平均动脉压和心率都处于正常范围内,无显著变化(P>0.05)。两组术后24 h的智力评分均下降(P<0.05),在术后72 h恢复术前水平,而治疗组术后24 h与72 h的智力评分均明显高于对照组(P<0.05)。治疗组术后过敏反应、呼吸抑制、心律失常、持续性低血压、疼痛等不良反应发生情况明显少于对照组(P<0.05)。结论丙泊酚联合利多卡因全麻对老年患者智力的影响比较小,同时能够减轻不良反应的发生,值得推广应用。

Objective To investigate the effects of propofol combined with lidocaine on the intelligence of elderly patients after general anesthesia.Methods 80 senile patients receiving selective abdominal surgery were equally and randomly divided into treatment group and control group. Both groups received the propofol-adjuvant general anesthesia. Based on that, the treatment group received propofol combined with lidocaine-adjuvant general anesthesia. Observation and recording were made in the anesthetic effects, changes in vital signs, and adverse events between the two groups. Results Both groups successfully finished the anesthesia and surgery. There was no significant difference in the operative time, anesthetic time, intraoperative blood loss, time of postoperative eye opening, extubation time, and postoperative response time between the two groups （P 〉 0.05）. The mean arterial pressure and heart rates at different time points in the two groups were in the normal range, and there was no significant change （P 〉 0.05）. The intelligence scores of the two groups all decreased 24 hours after the operation （P 〈 0.05） but returned to the preoperative levels 72 hours after the operation. The scores of the treatment group 24 hours and 72 hours after the operation were significantly higher than those of the control group （P 〈 0.05）. The incidence of postoperative allergic reaction, respiratory depression, arrhythmia, continuoushypotension, pain in the treatment group was significantly lower than that in the control group （P〈0.05）. Conelueion Propofol combined with lidocaine has little effects on the intelligence of senile patients and can reduce the incidence of adverse reactions at the same time, which is worthwhile to be promoted.