摘要
目的 研究丙泊酚、咪唑安定静脉复合麻醉联合吸入异氟烷对老年患者术后认知功能的影响.方法 入选ASA Ⅰ -Ⅱ级择期行腹腔镜手术的老年患者60例,随机分为咪唑安定组、丙泊酚组以及复合麻醉组,每组20例.咪唑安定组予以咪唑安定进行诱导,术中持续微量泵入咪唑安定;丙泊酚组予以丙泊酚进行诱导,术中持续微量泵入丙泊酚;复合麻醉组予以咪唑安定及丙泊酚进行诱导,术中继续予以咪唑安定和丙泊酚持续微量泵入,再吸入1％-2％异氟烷维持麻醉.观察记录3组术中心率、血压、血氧饱和度的变化及术后麻醉苏醒时间,分别于麻醉前24h、术后24h和72 h,对每组采用MMSE量表进行认知功能评分.结果 3组在术中心率、血压、脉搏血氧饱和度方面均无统计学差异（P＞0.05）;3组术后苏醒时间均有统计学差异（P＜0.05）,其中咪唑安定组最长,丙泊酚组次之,复合麻醉组最短.术后12h及24h,咪唑安定组和丙泊酚组MMSE评分均较复合麻醉组明显降低（P＜0.05）;术后72 h,咪唑安定组MMSE评分仍较复合麻醉组明显降低（P＜0.05）,但丙泊酚组与复合麻醉组相比无统计学差异（P＞0.05）.结论 在老年患者腹腔镜手术中,采用丙泊酚、咪唑安定静脉复合吸入异氟烷全身麻醉不仅安全,且术后苏醒快,对其术后认知功能影响较小.
Objective To investigate the influence of balanced anesthesia with propofol and midazolam combined with the inhalation of isoflurane on the postoperative cognitive function of senile patients. Methods 60 ASA Ⅰ - Ⅱ senile patients undergoing the selective laparoscopic operation were randomly and divided into midazolam, propofol group, and compound anesthesia groups with 20 in each group. Midazolam group received the induction with midazolam and the continuous micro pumping with midazolam during the operation. Propofol group received the induction with propofol and the continuous micro pumping with midazolam during the operation. The compound anesthesia group received the induction with both midazolam and propofol and the continuous micro pumping with the two medicines. And the inhalation with 1%-2% isoflurane was carried out to maintain the anesthesia. Observation and recording were made in the changes in intraoperative heart rate, blood pressure, saturation of blood oxygen and the anesthetic recovery time. The cognitive function scoring was made in each group by MMSE scale 24 h before the anesthesia and 24 h and 72 h after the operation. Results There was no significant difference in the intraoperative hear rate, blood pressure, and blood oxygen saturation among the three groups（P 〉 0.05）. The difference in recovery time of anesthesia was significant among the three groups （P 〈 0.05）, and the longest to the shortest time were midazolam, propofol, and the compound anesthesia groups. Compared with the MMSE scores of the compound group, those of midazolam and propofol groups significantly decreased（P〈 0.05） 12 h and 24 h after the operation. The scores of midazolam group still significantly decreased compared with those of the compound anesthesia group （P 〈 0.05）, while the difference between propofol and the compound anesthesia groups was not significant （P 〉 0.05） 72 h after the operation. Conclusion For the laparoscopic operation on senile patients, general balanced anesthesia with propofol and midazolam combined with the inhalation of isoflurane has the advantages of safety, fast anesthetic recovery time after operation, and less influence on postoperative cognitive function.
出处
《西南国防医药》
CAS
2015年第9期960-962,共3页
Medical Journal of National Defending Forces in Southwest China
关键词
老年
咪唑安定
丙泊酚
异氟烷
认知功能
senile patient
midazolam
propofol
isoflurane
cognitive function
