丙泊酚与瑞芬太尼静吸复合麻醉对老年腹腔镜下胆囊切除术患者术后认知功能的影响

摘要

目的：探讨靶控静脉输注丙泊酚复合瑞芬太尼麻醉与静吸复合麻醉对老年经腹腔镜胆囊切除术患者术后认知功能的影响。方法选取2009年1月至2014年1月该院收治的80例行胆囊切除术患者，随机分为靶控静脉麻醉组及静吸复合麻醉组各40例。观察两组患者术后恢复情况，并比较两组手术前后认知功能。结果两组患者苏醒时间、拔管时间比较差异均无统计学意义（P＞0．05）；靶控静脉麻醉组患者自主呼吸恢复时间、定向力恢复时间均长于静吸复合麻醉组（P＜0．05）。两组术前24 h和拔管后12 h的简易智能量表（MMSE）评分比较差异均无统计学意义（P＞0．05）；拔管后1、3 h靶控静脉麻醉组MMSE评分低于静吸复合麻醉组（P＜0．05）。结论丙泊酚与瑞芬太尼静吸复合麻醉较靶控静脉麻醉对老年腹腔镜下胆囊切除术后认知功能的恢复有更好的效果，且对术后认知功能影响较小，可降低老年患者术后认知功能障碍的发生，适用于老年患者。%Objective To observe the effect of propofol and remifentanil anesthesia by target controlled infusion and intravenous in-halation anesthesia on postoperative cognitive function of elderly cholecystectomy patients with laparoscopic.Methods 80 cases of cholecys-tectomy patients were randomly divided into target controlled infusion anesthesia and intravenous inhalation anesthesia groups,each group had 40 cases.The recovery of two groups were observed and compared the cognitive function of before and after operation.Results There were no significant differences in recovery time, extubation time of two groups( P>0.05) .Spontaneous breathing recovery time,orientation recovery time of target controlled infusion anesthesia group were longer than those of intravenous inhalation anesthesia group(P<0.05).MMSE score in target controlled infusion anesthesia group was lower than that of intravenous inhalation anesthesia group at 1 and 3 h after extubation( P<0.05).Conclusions Propofol and remifentanil anesthesia with target controlled infusion anesthesia on cognitive function in elderly patients after laparoscopic cholecystectomy has better recovery effect, little effect on postoperative cognitive function, which could reduce the inci-dence of postoperative cognitive function, itˊs suitable for elderly patients.