丙泊酚和七氟烷麻醉对老年患者普通胸外科手术后认知功能的影响

Influence by propofol and sevoflurane anesthesia on postoperative cognitive function in senile patients after general thoracic surgery

目的探讨老年普通胸外科患者应用丙泊酚和七氟烷麻醉对术后认知功能的影响。方法老年普通胸外科手术患者72例,按照数字随机分配原则分为对照组与研究组,各36例。对照组与研究组患者分别给予七氟烷和丙泊酚麻醉,采用简易精神状态检查表(MMSE)对两组不同时间段认知功能进行评估,并观察比较两组患者的自主呼吸恢复时间、睁眼时间及拔管时间。结果两组患者术后1、6、12 h的MMSE评分均明显比术前低,差异均具有统计学意义(P<0.05);研究组患者术后1、6、12 h的MMSE评分均明显比研究组高,差异均具有统计学意义(P<0.05);而两组患者术前及术后24 h的MMSE评分比较差异无统计学意义(P>0.05)。研究组自主呼吸恢复时间(8.74±1.02)min、睁眼时间(12.55±3.04)min及拔管时间(14.29±4.16)min均明显短于对照组的(12.47±2.33)、(16.83±1.64)、(21.72±2.48)min,差异均具有统计学意义(t=8.799、7.435、9.205,P<0.05)。结论丙泊酚对老年患者普外科手术后认知功能影响较小,值得推广。

Objective To investigate influence by propofol and sevoflurane anesthesia on postoperative cognitive function in senile patients after general thoracic surgery. Methods A total of 72 senile patients in general thoracic surgery were divided by random number table into control group and research group, with 36 casesin each group. The control group and the research group received respectively sevoflurane and propofol foranesthesia. Evaluation of cognitive function at different time points was made by mini-mental state examination(MMSE). Observation and comparison were made on autonomous respiration recovery time, eye opening timeand extubation time between the two groups. Results Both groups had obviously lower MMSE scores in 1, 6,12 h after operation than those before operation, and their differences all had statistical significance (P<0.05).The research group had all higher MMSE scores in 1, 6, 12 h after operation than the control group, and theirdifferences all had statistical significance (P<0.05). There was no statistically significant difference of MMSE scorebetween postoperative 24 h and that before operation in both groups (P>0.05). The research group had all shorter autonomous respiration recovery time as (8.74±1.02) min, eye opening time as (12.55±3.04) min and extubation time as (14.29±4.16) min than (12.47±2.33), (16.83±1.64) and (21.72±2.48) min in the control group. Their differences all had statistical significance (t=8.799, 7.435, 9.205, P<0.05). Conclusion Propofol shows less influence on postoperative cognitive function in senile patients after general surgery, and it is worth promoting.