Hansen M B, Bigler D R
Københavns Amts Sygehus i Gentofte, anaestesiafdelingen.
Ugeskr Laeger. 1992 Jul 13;154(29):2000-3.
Minor short-term depression of mental function is seen after anaesthesia and surgery. However, general anaesthesia does not seem to cause permanent damage or depress mental function beyond the first 2-4 postoperative days and no significant advantages of regional anaesthesia, as regards to cerebral function, are found after this period. Severe cases of long term mental deterioration after surgery and anaesthesia may be explained by other factors such as per- and postoperative complications. The risk of mental disturbance is increased in patients with psychiatric disease or presenile dementia and may be due to ongoing treatment with tricyclic antidepressant and neuroleptic drugs. Centrally acting cholinergic drugs, hypotension and hypoxia together with postoperative pain and sleep deprivation should be avoided.
麻醉和手术后会出现轻微的短期精神功能减退。然而,全身麻醉似乎不会造成永久性损害,也不会在术后头2至4天之后使精神功能进一步减退,在此之后未发现区域麻醉在脑功能方面有显著优势。手术和麻醉后长期精神衰退的严重病例可能由其他因素解释,如围手术期和术后并发症。患有精神疾病或早老性痴呆的患者发生精神障碍的风险增加,这可能与正在使用三环类抗抑郁药和抗精神病药物治疗有关。应避免使用中枢性胆碱能药物、低血压、缺氧以及术后疼痛和睡眠剥夺。