氟马西尼对高龄全身麻醉患者术后认知功能障碍和脑电双频指数的影响

Influence of flumazenil application on postoperative cognitive dysfunction and bispectral index in elderly patients with general anesthesia

目的探讨高龄全身麻醉手术患者术后应用氟马西尼对认知功能障碍(POCD)和脑电双频指数(BIS)的影响。方法选取拟行全身麻醉下腹部手术的高龄患者120例,随机均分为试验组和对照组,各60例,2组患者均采用静脉复合麻醉,试验组术后静脉注射氟马西尼0.3mg,对照组给予等量生理盐水,对比2组不同时间的BIS和简易智力量表(MMSE)评分等指标的差异。结果 2组患者的瑞芬太尼用量、麻醉时间、手术出血量、尿量、补液量以及给药前和给药2min的BIS差异均无统计学意义(P>0.05)。给药后4,10和20min,试验组的BIS监测值均显著高于对照组(P<0.05),术后24和48h的MMSE评分均显著高于对照组(P<0.05),给药1,5和10min的OAA/S评分均显著高于对照组(P<0.05)。结论氟马西尼有利于促进高龄全身麻醉手术患者认知恢复、迅速提升患者的BIS值。

Objective To study the influence of flumazenil application on postoperative cognitive dysfunction （POCD） and bispectral index （BIS） in elderly patients with general anesthesia. Methods 120 elderly patients,selected from a hospital undergoing abdominal surgery under general anesthesia,were randomly assigned into experimental group and control group,each 60 cases.The 2 groups of patients were treated with same intravenous anesthesia.After surgery,the experimental group were given 0.3 mg flumazenil intravenously,while the control group was given normal saline.The BIS,simple intelligence scale （MMSE） score and other indicators were compared between the 2 groups. Results Before or after the drug administration 2 min,the application amount of remifentanil,the duration of anesthesia,the blood loss,the urine output,and the amount of fluid showed no significant difference （ P〉 0.05）.After administration 4,10,20 min,the BIS monitoring values of the experimental group were significantly higher than the control group （P〈0.05）.After 24 and 48 h,the MMSE score of the experimental group was significantly higher than the control group （P〈0.05）.After 1,5,10 min,the OAA/S scores of the experimental group were significantly higher than the control group （P〈0.05）. Conclusion Flumazenil could promote the awareness in elderly patients undergoing general anesthesia recovery and increase the BIS values rapidly.