丙泊酚与芬太尼或瑞芬太尼复合麻醉对老年全身麻醉后苏醒时间及认知功能的影响

摘要

目的：探讨丙泊酚与芬太尼或瑞芬太尼复合麻醉对老年全身麻醉后苏醒时间及认知功能的影响。方法选取72例老年全身麻醉手术患者，用随机数字表将纳入的72例老年全身麻醉手术患者分为观察组(n=36)和对照组(n=36)。观察组采用丙泊酚与瑞芬太尼复合麻醉，对照组采用丙泊酚与芬太尼复合麻醉。观察两组患者麻醉后苏醒时间及认知功能的变化。结果与对照组比较，观察组患者麻醉后自主呼吸恢复时间、呼之睁眼时间、拔管时间以及定向力恢复时间均偏短(P<0.05或P<0.01)。麻醉前两组患者MMSE评分之间比较差异不明显(P>0.05)。麻醉后两组患者MMSE评分在6h和12h时均有不同程度的下降(P<0.05或P<0.01)，且观察组下降值明显小于观察组(P<0.05)，麻醉后24h两组患者MMSE评分均上升至麻醉前水平(P>0.05)。结论丙泊酚与瑞芬太尼复合麻醉患者麻醉后苏醒较丙泊酚与芬太尼复合麻醉更快，能明显缩短患者的气管插管时间，减少患者术后苏醒监护时间，且对老年患者麻醉后早期认知功能的影响较少。%Objective To discuss influence of combined anesthesia of propofol and fentanyl or remifentanil on revival time and cognitive function of senile patients treated with general anesthesia. Methods A total of 72 cases of senile patients were selected and divided into observation group(n=36 cases)and control group(n=36 cases) by table of ran-dom number. The patients in observation group were given propofol and remifentanil, while the patients in control group were given combined anesthesia of propofol and fentanyl. The changes of revival time and cognitive function of patients in two groups after the anesthesia were observed and compared. Results The spontaneous breathing recovery time,eyes-open time,time of extubation and orientation recovery time of patients in observation group after the anes-thesia were all much shorter than those in control group (P<0.05 or P<0.01). After comparing the MMSE scores of pa-tients in two groups before anesthesia, no statistical differences appeared (P>0.05). The MMSE scores at 6 and 12 hours after the anesthesia obviously declined than before(P<0.05 or P<0.01),and the declining rate of patients in ob-servation group was much lower than that in observation group (P<0.05). The MMSE score at 24 hours after the anes-thesia came back to the same level as that before anesthesia(P>0.05). Conclusion Compared with combined anesthesia of propofol and fentanyl, the revival time, tracheal intubation time and postoperative recovery monitoring time of pa-tients,who are given the combined anesthesia of propofol and remifentanil,are all much shorter,and the influence on cognitive function after anesthesia is much smaller for senile patients.