Ghoneim M M, Block R I
Department of Anesthesia, University of Iowa, Iowa City, IA 52244, USA.
Acta Anaesthesiol Scand. 2007 Sep;51(8):1054-61. doi: 10.1111/j.1399-6576.2007.01378.x.
Information about anterograde and retrograde amnesias in the immediate peri-operative period is scarce. During this period, assessment of memory for real-life events is also rare. We hypothesized that there would be both anterograde and retrograde amnesias and memory for peri-operative events would be better than for verbal memory.
We studied 40 patients who underwent general anesthesia and surgery and 19 control volunteers who were matched to the patients but did not have surgery. Patients completed the state anxiety part of the Spielberger State-Trait Anxiety Inventory in the pre-operative period. They were presented with three word lists in the holding area, the operating room before induction of anesthesia and the recovery room. Memory for the words was tested the next day by recall and recognition tests. Memory for events that happened on the day of surgery was tested by administering a questionnaire. The control subjects were tested similarly but did not complete the events questionnaire. Retrograde amnesia would be demonstrated by a decline in patients' memory from the holding area to the operating room which exceeded any corresponding changes in controls; anterograde amnesia would be demonstrated by memory impairment of the patients in the recovery room, relative to controls.
Recall and recognition of words were significantly impaired in the recovery room with a decline from 12% in the holding area to zero% in the recovery room for recall and from 43% to 7% for recognition. The decline in memory from the holding area to the operating room was not significantly greater in patients than in controls, 80% vs. 56% for recall and 27% vs. 14% for recognition. There were no significant differences for recognition of events which happened in the three rooms.
We were unable to detect retrograde amnesia. Patients' memory for neutral stimuli in the recovery room was severely impaired. The events questionnaire proved to be insensitive.
关于围手术期即刻顺行性和逆行性遗忘的信息匮乏。在此期间，对现实生活事件的记忆评估也很少见。我们假设会同时存在顺行性和逆行性遗忘，且围手术期事件的记忆会优于言语记忆。
我们研究了40例接受全身麻醉和手术的患者以及19名与患者匹配但未接受手术的对照志愿者。患者在术前完成了斯皮尔伯格状态-特质焦虑量表的状态焦虑部分。他们在等待区、麻醉诱导前的手术室和恢复室分别看到三个单词列表。次日通过回忆和识别测试来检测对这些单词的记忆。通过发放问卷来测试对手术当天发生事件的记忆。对照受试者接受类似测试，但未完成事件问卷。如果患者从等待区到手术室的记忆下降超过对照组的任何相应变化，则表明存在逆行性遗忘；相对于对照组，如果患者在恢复室存在记忆障碍，则表明存在顺行性遗忘。
恢复室中单词的回忆和识别明显受损，回忆从等待区的12%降至恢复室的零，识别从43%降至7%。患者从等待区到手术室的记忆下降幅度并不比对照组显著更大，回忆分别为80%对56%，识别分别为27%对14%。对在三个房间发生事件的识别没有显著差异。
我们未能检测到逆行性遗忘。患者在恢复室对中性刺激的记忆严重受损。事实证明事件问卷不敏感。
