Anaesthesia and Pain Management Unit, Department of Pharmacology, University of Melbourne, Carlton, Victoria.
Anaesthesia. 2011 Jun;66(6):455-64. doi: 10.1111/j.1365-2044.2011.06704.x. Epub 2011 Apr 18.
We investigated the influence of either propofol or desflurane on the incidence of postoperative cognitive dysfunction in a randomised trial of 180 patients undergoing coronary artery bypass surgery. The primary outcome was incidence of postoperative cognitive dysfunction at 3 months, defined as ≥1 SD deterioration in two or more of 12 neurocognitive tests. Secondary outcomes included early postoperative cognitive dysfunction (between days three and seven), delirium on day one, morbidity and length of hospital stay. Early postoperative cognitive dysfunction was significantly higher with propofol compared with desflurane (56/84 (67.5%) vs 41/83 (49.4%), respectively, p=0.018), but this effect was not seen at 3 months (10/87 (11.2%) vs 9/90 (10.0%), respectively. There was no difference in delirium (7/89 (7.9%) vs 12/91 (13.2%), respectively, length of hospital stay (median (IQR [range]) 7 (6-9 [4-15]) vs 6 (5-7 [5-16) days, respectively or other morbidities. Desflurane was associated with reduced early cognitive dysfunction.
我们在一项随机试验中研究了异丙酚或地氟醚对 180 例接受冠状动脉旁路手术的患者术后认知功能障碍发生率的影响。主要结局是术后 3 个月时术后认知功能障碍的发生率，定义为 12 项神经认知测试中两项或更多项的≥1 个标准差恶化。次要结局包括术后早期认知功能障碍（第 3 天至第 7 天）、第 1 天谵妄、发病率和住院时间。与地氟醚相比，异丙酚的术后早期认知功能障碍明显更高（分别为 56/84（67.5%）和 41/83（49.4%），p=0.018），但在 3 个月时未见这种差异（分别为 10/87（11.2%）和 9/90（10.0%）。谵妄（分别为 7/89（7.9%）和 12/91（13.2%））、住院时间（中位数（IQR[范围]）分别为 7（6-9[4-15]）和 6（5-7[5-16]）天）或其他发病率均无差异。地氟醚与减少早期认知功能障碍相关。
