地氟醚与七氟醚麻醉对术后认知功能的影响

Effects of Desflurane and Sevoflurane Anesthesia on Postoperative Cognitive Function

目的分析地氟醚与七氟醚麻醉对老年患者术后认知功能的影响。方法选取2019年2月-2020年1月入组本院科室收治的老年手术患者共100例为研究对象,随机分组,对照组的患者麻醉的药物选择地氟醚,观察组麻醉的药物选择七氟醚。比较两组术前、术后不同时间MMSE评分、呼吸恢复时间、恢复吞咽反射时间、睁眼时间、气管导管拔除时间、不同时间患者S100β蛋白水平、NSE水平、麻醉成功率、认知功能障碍发生率。结果观察组术前、术后不同时间MMSE评分、呼吸恢复时间、恢复吞咽反射时间、睁眼时间、气管导管拔除时间和对照组相应的指标差异无统计学意义,两组术后1~3h的MMSE评分较术前均有所降低,P <0.05,术后6、24 h逐渐恢复术前水平,P> 0.05。两组患者术前相关指标比较,P> 0.05,而术后1 h和术后3 h两组S100β蛋白水平、NSE水平均显著升高,P <0.05,且两组升高的程度相似。观察组麻醉成功率和对照组均是100%,P>0.05。两组认知功能障碍发生率对比差异无统计学意义,P> 0.05。结论地氟醚与七氟醚麻醉对老年患者术后认知功能的影响相似,均可一定程度影响术后的认知功能。

Objective To analyze the effects of desflurane and sevoflurane anesthesia on cognitive function in elderly patients. Methods A total of 100 elderly surgical patients admitted to our hospital from February 2019 to January 2020 were randomly divided into two groups. Desflurane was selected as the anesthesia drug in the control group and sevoflurane as the anesthesia drug in the observation group. The MMSE score, respiratory recovery time, swallowing reflex recovery time, eye opening time, tracheal tube extubation time, S100 β protein level, NSE level, anesthesia success rate and cognitive dysfunction rate of the two groups were compared. Results There were no significant differences in MMSE scores, respiratory recovery time, recovery swallowing time, eye opening time, tracheal tube removal time and corresponding indicators in the control group before and after surgery. The MMSE scores were all lower than those before surgery, P < 0.05, and gradually returned to preoperative levels at 6, 24 hours after surgery, P > 0.05. The comparison of related indexes before operation in the two groups was P > 0.05, and the levels of S100β protein and NSE level in the two groups increased significantly at 1 hour and 3 hours after operation, P < 0.05, and the degree of increase was similar in the two groups. The anesthesia success rate in the observation group and the control group were 100%, P > 0.05. There was no significant difference in the incidence of cognitive dysfunction between the two groups, P > 0.05. Conclusion Desflurane and sevoflurane anesthesia have similar effects on postoperative cognitive function in elderly patients, and both can affect postoperative cognitive function to some extent.