摘要
目的:研究瑞芬太尼、丙泊酚全凭静脉麻醉对老年患者开胸手术后认知功能恢复的影响。方法:选择2003-01/2004-12年潍坊市人民医院肿瘤外科和胸外科收治的食管癌患者,随机选择40例择期行食管癌根治术患者,ASAⅠ～Ⅱ级,年龄≤65岁,术前无神经、精神系统疾病史或药物滥用史,受教育程度:小学。其中,20例麻醉诱导与维持为:瑞芬太尼+丙泊酚+卡肌宁(瑞芬太尼组),20例为芬太尼+丙泊酚+卡肌宁(芬太尼组)。分别在麻醉手术前一晚、术后30min,2,6,12,24,48h应用简易精神状态量表评定其认知功能。结果:两组自主呼吸恢复时间相似,睁眼时间(4.1±2.6vs2.2±1.0)、拔管时间(6.0±3.1vs3.3±2.0)、陈述自己姓名、出生日期时间(8.9±5.8vs4.0±2.5),瑞芬太尼组明显比芬太尼组短(P<0.01)。与术前相比,两组患者术后30min,2h简易精神状态量表评分值均明显降低(P<0.01);瑞芬太尼组6h评分与术前比无明显差异,芬太尼组简易精神状态量表评分值在术后12h与术前比无明显差异(P>0.05)。结论:瑞芬太尼、丙泊酚全凭静脉麻醉对老年患者开胸手术后认知功能影响小,恢复快。
AIM:To study the recovery of elderly patients'cognitive function after total i ntravenous anesthesia with remifentanil propofol. METHODS:From January 2003 to December 2004,forty ASA I-II patients with esoph ageal carcinoma(less than or equal 65 years old) undergoing esophagectomy in the Department of Surgical Oncology and Department of Chest Surgery in Weifang Peop le's Hpspital were equally randomized to receive either remifentanil propofol tracium anesthesia(remifentanil group) or fentanyl propofol tracium anesthesia (fentanyl group).The patients had no histories of nervous and mental diseases or drug abuse,and they graduated from primary schools.Cognitive function was asses sed by Mini Mental State Examination(MMSE) respectively the night before operat ion,30 minutes,2,6,12,24 and 48 hours after surgery. RESULTS:The time from the conclusion of anesthesia to spontaneous respiration was similar in both groups.Time for eye opening(4.1±2.6 vs 2.2±1.0),for extuba tion(6.0±3.1 vs 3.3±2.0),and for verbalization of names and birth dates(8.9±5 .8 vs 4.0±2.5) were significantly shorter in the remifentanil group than in the fentanyl group(P< 0.01).As compared before operation,the MMSE scores were lower at 30 minutes and 2 hours after operation in both groups(P< 0.01).MMSE score at postoperative 6 hours was insignificant different from that of preoperation in remifentanil group,and that at postoperative 12 hours was insignificantly differ ent from that of preoperation in fentanyl group(P >0.05). CONCLUSION:Recovery of cognitive function is obviously faster,and side effects are less after total intravenous anesthesia of remifentanil propofol,as compar ed with fentanyl propofol anesthesia in elderly patients undergoing esophagecto my.
出处
《中国临床康复》
CSCD
北大核心
2005年第14期107-109,共3页
Chinese Journal of Clinical Rehabilitation
