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七氟醚麻醉对接受冠状动脉搭桥手术患者的术后认知功能障碍没有影响。

Sevoflurane anesthesia did not affect postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft surgery.

作者信息

Kadoi Yuji, Goto Fumio

机构信息

Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Japan.

出版信息

J Anesth. 2007;21(3):330-5. doi: 10.1007/s00540-007-0537-7. Epub 2007 Aug 1.

Abstract

PURPOSE

The purpose of this study was to retrospectively examine whether sevoflurane anesthesia had any ameliorative effects on postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft (CABG) surgery.

METHODS

One hundred and nine patients underwent elective CABG surgery at our institution from May 1999 to May 2001. From May 1999 to August 2000, the main anesthetic regime used included a propofol infusion with no volatile anesthetic being administered during the surgery. From September 2000 to May 2001, the main anesthetic regime used was 1.5%-2.0% sevoflurane from the postinduction period until the end of the surgery. All patients underwent a battery of neurological and neuropsychological tests 1 day before and 6 months after the operation.

RESULTS

The use of sevoflurane did not have any significant effects on the postoperative levels of cognitive dysfunction. In contrast, multiple logistic analysis showed that age [odds ratio (OR), 1.3; P = 0.047], diabetes mellitus (OR, 2.5; P = 0.03), and atherosclerosis of the ascending aorta (OR, 1.4; P = 0.047) appeared to be predictive factors of postoperative cognitive dysfunction.

CONCLUSION

This retrospective study showed no relationship between postoperative cognitive dysfunction and the use of sevoflurane.

摘要

目的

本研究的目的是回顾性研究七氟醚麻醉对接受冠状动脉搭桥术(CABG)的患者术后认知功能障碍是否有改善作用。

方法

1999年5月至2001年5月,109例患者在我院接受择期CABG手术。1999年5月至2000年8月,主要麻醉方案包括术中输注丙泊酚,不使用挥发性麻醉剂。2000年9月至2001年5月,主要麻醉方案是从诱导期至手术结束使用1.5%-2.0%的七氟醚。所有患者在术前1天和术后6个月接受了一系列神经学和神经心理学测试。

结果

七氟醚的使用对术后认知功能障碍水平没有显著影响。相比之下,多因素逻辑分析显示年龄[比值比(OR),1.3;P = 0.047]、糖尿病(OR,2.5;P = 0.03)和升主动脉粥样硬化(OR,1.4;P = 0.047)似乎是术后认知功能障碍的预测因素。

结论

这项回顾性研究表明术后认知功能障碍与七氟醚的使用之间没有关联。

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