七氟醚丙泊酚静吸复合麻醉对老年患者胃癌根治术术后早期认知功能的影响

摘要

Objective To compare the effect of sevoflurane inhalation combined with intravenous propofol anesthesia and propofol total intravenous anesthesia ( TIVA) on postoperative cognitive function in senile patients with gastric cancer. Methods 36 ASA I~II patients aged 60~75y for selective gastric cancer radical operation were randomly assigned to 2 groups. In group (S+P), patients received sevoflurane combined with intravenous propofol anesthesia whereas group P patients were subjected to propofol TIVA during the period of general anesthesia maintenance. In either group, Mini-mental state examination (MMSE) scores were measured at day 1 prior to surgery as well as 3, 6, 24, 72, 96 hours after postoperation. Results Compared with pre-anesthesia condition, MMSE at 3 and 6 hours after postoperation following surgery attenuated notably both in (S+P) groups and P groups (P<0.05 or P<0.01) whereas 72 hours after postoperation only statistical significance was recorded in (S+P) groups. Conclusion Compared with TIVA, sevoflurane inhalation combined with intravenous anesthesia may increase the rate of postsurgical cognitive dysfunction occurrence.%目的：探讨七氟醚丙泊酚复合麻醉对于老年胃癌患者术后早期认知功能的影响。方法择期食管癌根治术老年患者36例， ASA I~II级，年龄60~75周岁，随机均分为七氟醚丙泊酚复合麻醉组(S+P组)和丙泊酚全凭静脉组(P组)。分别于手术前1天、术后第3、6、24、72、96 h分别测定简易精神状态量表(MMSE)评分。结果与手术前1 d比较，两组患者术后3、6 h MMSE评分均降低(P<0.05)，但是术后72 h仅S+P 组评分降低。S 组术后出现轻度认知功能障碍的患者为4例(22.2%)， P组为2例(11.1%)。结论与丙泊酚全凭静脉麻醉相比，七氟醚丙泊酚复合麻醉并不增加术后早期认知功能障碍的发生率。