摘要
目的:探讨瑞芬太尼复合丙泊酚静脉麻醉下联合硝酸甘油控制性降压对老年患者术后认知功能的影响。方法:择期须行控制性降压手术的老年患者60例(鼻内镜手术、髋关节置换术、脊椎手术),ASA I^II级,性别不限,年龄65~75岁,随机分为2组(对照组和控制性降压组)。控制性降压组于手术开始后静脉输注硝酸甘油1.0~3.0μg.kg-1.min-1行控制性降压,维持平均动脉压(MAP)较麻醉前降低30%左右(不低于60mmHg)。对照组不行控制性降压。两组于麻醉诱导前(基础状态)及术后24、48h应用简易智能状态检查法(MMSE)评估术后认知功能。结果:控制性降压组术中MAP较对照组明显降低(P<0.05);与基础值比较,术后24、48h两组MMSE评分差异无统计学意义(P>0.05);两组间MMSE评分差异无统计学意义(P>0.05),均未发生术后认知功能障碍。结论:硝酸甘油1.0~3.0μg.kg-1.min-1联合瑞芬太尼复合丙泊酚麻醉下行控制性降压对老年患者术后认知功能无明显影响。
Objective： To study the influence of anaesthesia with remifentanil compounding propofol combined with nitroglycerin controlling hypotension on elders＇ cognition. Methods： 60 cases of patients, aged 6575, ASA grade Ⅰ or Ⅱ, were randomly divided into 2 groups. In experimental group, nitroglycerin was infused to make controlling hypotension, which decreased 30% of MAP. In control group, no hypotension was induced. And the Mini-mental state examination {MMSE} was applied to evaluate cognition function before anesthesia and 24h and 48h after surgery.Results： In experimental group, MAP was significantly lower than that in control group. Compared with the baseline, there had no significant difference of MMES scores at the time of 24h and 48h after surgery. And no significant difference was observed between the experimental and control group. Conclusion： There has no significant influence of anaesthesia with remifentanil compounding propofol combined with nitroglycerin controlling hypotension on elders＇ postoperative cognition.
出处
《四川省卫生管理干部学院学报》
2009年第1期19-21,共3页
Journal of Sichuan Continuing Education College of Medical Sciences
关键词
硝酸甘油
降压
控制性
老年人
认知功能
Nitroglycerin
Hypotension
Controlling
Elder
Contrition.
