三种麻醉方法对老年患者术后认知功能影响的比较

目的探讨异氟烷、地氟烷以及丙泊酚维持麻醉对老年患者术后认知功能恢复的影响。方法96例老年腹部手术患者随机分配到三组,地氟烷组(D组n=32)、异氟烷组(Ⅰ组n=32)和丙泊酚组(B组n=32)。三组麻醉诱导方法相同:芬太尼2μg/kg、依托咪酯0.2mg/kg、阿曲库铵0.5mg/kg诱导插管,分别以1.3MAC的地氟烷、异氟烷和6~8mg/kg丙泊酚维持麻醉,分别观察患者术前、术后1,6,12,24,48h患者认知功能MMS值的变化。结果地氟烷组和丙泊酚组认知功能在术后1~12h三个时间点MMS值降低,24h及以后与术前无差异,异氟烷组认知功能在术后1~24h四个时间点MMS值降低,48h及以后与术前无差异。结论仅从术后认知功能的恢复方面考虑,丙泊酚和地氟烷用于老年病人麻醉较异氟烷更优。

Tile Effects of Three Anesthetic Techniques on Postoperative Cognitive Function in Aged Patients

Objective To compare the postoperative cognitive function with the three different anesthetic treatment in aged patients. Methods Ninety-six patients (61 male and 35 female) aging 65-75 years undergoing abdominal surgical operation were randomized into three groups: Following the induction, isoflurane (group I) or desflurane (group D) was respectively inhaled to maintain anesthesia, and the third group received the infusion of propofol (Group P) to maintain anesthesia. The cognitive function was assessed before induction (pre-operation) and at l, 6, 12, 24 and 48 h after operation. Mini-Mental State (MMS) test was used to compare the incidence of cognitive dysfunction among the three groups. Results The MMS in group D and Group P at 1, 6, and 12 h after operation was lower than that of pre-operation, but there was no difference after 24 h of postoperation. The MMS in group I at l, 6, 12 and 24 h after operation was lower than that of preoperation, but after 48 h of postoperation, there was no difference. Conclusion According to the recovery of postoperative cognitive function, this study suggests that the maintaining anesthesia with desflurane and propofol is advantageous over the maintaining anesthesia with isoflurane.