瑞芬太尼及丙泊酚静脉用药对高龄患者术后认知功能恢复的影响

目的探讨瑞芬太尼及丙泊酚对高龄患者静脉麻醉后认知功能恢复的影响。方法2009年1月-2013年1月我院行食管癌根治术患者32例，年龄70-80岁，ASAⅠ-Ⅱ级，随机分为两组，分别采用瑞芬太尼＋丙泊酚＋卡肌宁（瑞芬太尼组，n=16）及芬太尼＋丙泊酚＋卡肌宁（芬太尼组，n=16）行麻醉诱导维持。术后记录自主呼吸恢复时间、呼之睁眼时间、拔管时间及自我陈述时间，分别于术前24h、术后2h、24h应用简易精神状态量表评估患者认知功能。结果两组自主呼吸恢复时间未见显著差异（P〉0．05），瑞芬太尼组呼之睁眼时间、拔管时间及陈述自己姓名时间均明显早于芬太尼组（P〈0．05）。术后2h两组简易精神状态量表评分均较术前明显降低（P〈0．05），术后24h评分两组较术前均无统计学差异（P〉0．05）。结论瑞芬太尼与丙泊酚合用对高龄患者术后认知功能影响小，值得临床推广应用。

Effect of Intravenous Administration of Remifentanil and Propofol on Postoperative Recovery of Cogni- tive Function in Aged Patients

Objective To study the effect of intravenous administration of remifentanil and propofol on postoperative recovery of cognitive function in aged patients. Methods From January 2009 to Janu- ary 2013, a total of 32 esophageal cancer patients aged from 70 to 80 years, with ASA Ⅰ to Ⅱ , per- formed radical resection were randomized into two groups, with 16 cases for each. Rcmifentanil group was performed anesthesia induction and maintenance with remifentanil, propofol and tracrium, and fentanyl group was with fentanyl, propofol and tracrium. The time of spontaneously breathing, goggle, extubation and consciousness were recorded after operation. Simple mental state questionnaire was used to assess the patients＇ cognitive function at the time points of 24 h before the operation, 2 h and 24 h after the operation. Results There was no statistic difference in spontaneous breathing recovery time between two groups （P 〉 0.05 ） , but the time of goggle, extubation and consciousness in remifentanil group was shorter than those in fentanyl group （ P 〈 0.05 ）. In both two groups, the simple mental status score was decreased at the time point of 2 h after operation than at preoperation （ P 〈0. 05 ） , and no statistic difference between preoperation and 24 h after operation （P 〉 0.05 ）. Conclusion Intravenous administration of remifentanil and propofol can obtain cognitive function recovery in short time after the operation with less side effect, therefore is worthy to be popularized.