老年患者手术应用不同全麻麻醉方式对术后认知功能影响的比较分析

目的 分析比较老年患者手术应用不同全麻麻醉方式对其术后认知功能的影响.方法 将72例老年患者按照麻醉方式不同,随机分为异氟烷组、七氟烷组及全凭静脉组.比较三组患者术后认知功能恢复情况(包括手术前后MMSE评分、术后不良反应发生率与术后睁眼时间).结果 三组患者性别、年龄、手术与麻醉时间、输血与出血量等比较,差异无统计学意义.全凭静脉组拔管时间(10.11±1.90)min]显著低于异氟烷组(21.13±2.60) min]与七氟烷组(18.55±3.50) min];全凭静脉组睁眼时间(15.07±4.21) min]亦显著低于异氟烷组(31.20±3.90)min]与七氟烷组(28.15±10.11)min];差异有统计学意义(P＜0.05).三组患者均未出现明显不良反应.结论 吸入麻醉和全凭静脉麻醉两种麻醉方法都适于临床老年手术麻醉,都能够在手术后短时期恢复患者认知功能,但全凭静脉麻醉术后拔管与睁眼时间比吸入麻醉术后恢复时间短,值得临床推广应用.

Influence of different general anesthesia methods on postoperative cognitive function in elderly patients

Objective To analyze the influence of different general anesthesia methods on postoperative cognitive function in elderly patients.Methods 72 elderly patients were randomly divided an isoflurane group,a sevoflurane group,and an intravenous group according to different anesthesia methods.The results were analyzed and compared between these three groups.Results There were no statistical differences in gender,age,operation time,anesthesia time,blood transfusion,and bleeding volume between these three groups.The extubation time and the eye-opening time were (10.11±1.90) min and (15.07±4.21) min in the intravenous group,(21.13±2.60) min and (31.20±3.90) min in the isoflurane group,and (18.55±3.50) min and (28.15±10.1 l) min in the sevoflurane group,with statistical differences (P＜0.05).No severe adverse reaction occurred in all the three groups.Conclusions Inhalation anesthesia and total intravenous anesthesia are both suitable for elderly operation patients and both can decrease cognitive function in short time after operation,but total intravenous anesthesia has shorter recovery time than inhalation anesthesia,so it is worth being clinically generalized.