七氟醚与丙泊酚静脉麻醉对老年髋关节置换术患者 认知功能的影响

目的 比较七氟醚复合静脉麻醉与丙泊酚静脉麻醉对老年髋关节置换术患者认知功能的影响。方法 择期拟行髋关节置换术老年患者60例，采用随机数字表法分为七氟醚组和丙泊酚组,各30例，七氟醚组常规麻醉诱导后予2.5%~3.5%七氟醚,丙泊酚组常规麻醉诱导后予丙泊酚静脉靶控输注，分别于术前1 d 和术后7 d行镇静/警觉评分和简明精神状态量表评分评价患者认知功能。结果 丙泊酚组OAA/s评分（4.21±0.40）分，高于七氟醚组（3.98±0.35）分，差异有统计学意义（P＜0.05）；术后7 d丙泊酚组MMSE评分、语言能力，高于七氟醚组，差异有统计学意义（P＜0.05），定向力、记忆力、注意力和计算力、回忆能力与七氟醚组，差异无统计学意义（P＞0.05）。结论 丙泊酚静脉麻醉引起的术后认知功能损害低于七氟醚复合静脉麻醉，是老年患者更为理想的麻醉方案。

Effects of Sevoflurane and Propofol Intravenous Anesthesia on Cognitive Function in Elderly Patients Undergoing Hip Replacement

Abstract:Objective To compare the effects of sevoflurane combined intravenous anesthesia and propofol intravenous anesthesia on cognitive function in elderly patients undergoing hip arthroplasty.Methods 60 elderly patients undergoing hip arthroplasty were randomly divided into sevoflurane group(n=30)and propofol group(n=30).The sevoflurane group received 2.5%~3.5% sevoflurane after induction of routine anesthesia.Propofol group was given target intravenous infusion of propofol after induction of routine anesthesia,The patientsundefined cognitive function was evaluated 1 d before operation and 7 d after operation by sedation/alertness scale and brief mental state scale.Results The OAA/s score of propofol group(4.21±0.40)was higher than that of sevoflurane group(3.98±0.35),the difference was significant(P<0.05),the MMSE score and language ability of the 7 d propofol group after operation were higher than those in the sevoflurane group,the difference was statistically significant(P<0.05).There was no significant difference in orientation, memory, attention,calculation and recall between sevoflurane group and sevoflurane group(P>0.05).Conclusion Propofol intravenous anesthesia induced postoperative cognitive impairment is lower than sevoflurane combined intravenous anesthesia,is an ideal anesthesia program for elderly patients.