七氟烷及丙泊酚全身麻醉用于无痛人工流产术时对认知功能的影响

目的:探讨不同浓度七氟烷及丙泊酚全身麻醉用于无痛人工流产术时对患者认知功能的影响。方法:120例行择期无痛人工流产术的早孕患者,随机分为丙泊酚组(1.5mg/kg)(A组)、8%七氟烷诱导组(B组)、6%七氟烷诱导组(C组),分别采用丙泊酚静脉麻醉和七氟烷吸入麻醉方法。记录诱导前(T0)、诱导后即刻(T1)、术中(T2)、术毕即刻(T3)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)心率(HR)、3组的入睡时间(t1)、睁眼时间(t2)及不良反应,全部患者于手术后5 min行神经行为认知状态检查(NCSE)。结果:C组在诱导后即刻,SBP、DBP、MAP和HR与A组、B组比较有统计学意义(P<0.05);术中、术毕的SBP、DBP、MAP和HR,三者比较无统计学意义(P>0.05);B组、C组与A组相比,入睡时间及睁眼时间,3组之间比较无显著差异(P>0.05);B组、C组与A组比较,定向力、计算能力及记忆能力,差异有统计学意义(P<0.05),而B组和C组比较无统计学意义(P>0.05)。结论:6%七氟烷用于无痛人工流产诱导,不仅可以维持满意的镇静效果和血液动力学的平稳,而且对认知功能无影响。

General anesthetic sevoflurane and propofol on recovery of postoperative cognitive function in patients undergone painlessly induced abortion

Objective：To investigate the effects of sevoflurane and propofol and sevolfurane at different dose on the early recovery of postoperative cognitive function in patients undergone painlessly induced abortion under general anesthesia.Methods：One hundred and twenty patients scheduled for painlessly induced abortion were randomized into 3 groups（n=30）.Group A was injected intravenously propofol at dose of 1.5 mg/kg for induction.Group B was given 8% sevoflurane inhalation for induction and Group C,6% sevoflurane inhalation for induction.During the surgery,we maintained the bispectral（BIS） value at 40～60 and the clinical data were kept regarding systolic blood pressure（SBP）,diastolic blood pressure（DBP）,mean arterial blood pressure（MAP） and heart rate（HR） by T0（before induction）,T1（the moment of induction）,T2（intraoperation） and T3（right after the operation）,respectively,as well as the time of falling asleep（t0） and waking up（t1） and adverse reaction.All patients received neurobehavioral cognitive status examination（NCSE） test.Results：Group C was different as compared with group A and B concerning SBP,DBP,MAP and HR right after the induction（P0.05）,whereas the three groups showed no difference regarding SBP,DBP,MAP and HR in operation and postoperation,and the same results were seen in the three groups with respect to the time of falling asleep and waking up（P0.05）.Compared with group A,group B and C appeared better at orientation,numeral calculation and memory（P0.05）,yet showing no difference between group B and C（P0.05）.Conclusion：6% sevolfurane seems excellent in painlessly induced abortion,for it can achieve good sedation and resultant haemodynamics but is free of interference with the cognitive function of patients.