氟马西尼对术后认知功能的影响

术后认知功能障碍的发生可能与围术期某些用药有关.这类药物,尤其是部分麻醉药物可产生遗忘,学习能力、注意力、记忆力、定向力降低等认知功能障碍.苯二氮蔁(benzodiazepine,BDZ)受体拮抗剂氟马西尼不仅可通过影响γ-氨基丁酸(gamma-aminobutyrie acid,GABA)受体促进咪达唑仑、丙泊酚、吸入麻醉药的麻醉后苏醒,还能逆转这些药物所致的认知和精神运动功能的损害,有助于患者术后认知功能的及早恢复.氟马西尼联用5-HT3受体阻断剂恩丹西酮可促进乙酰胆碱的释放,从而推测这种联合用药可拮抗与胆碱能水平减少或功能低下相关的认知功能损害.

Effect of flumazenil on postoperative cognitive function

Aged patients are confronted with high risk of cognitive dysfunction after major non--cardiac surgery under general anesthesia. Some anesthetics may cause cognitive impairments such as amnesia, disorientation, learning deficit. Flumazenil, a gammaaminobutyric acid (GABA) receptor benzodiazepine site antagonist, can shorten the recovery period after withdrawing from sedation with midazolam, propofol and inhalation anesthetics. Moreover, flumazenil can reverse some cognitive and psychomotor impairment without bringing major side effects. Whether flumazenil could be applied to treatment of mental disorder with cholinergic dysfunction is still in controversy.