Nielson W R, Gelb A W, Casey J E, Penny F J, Merchant R N, Manninen P H
Department of Anaesthesia, University Hospital, London, Ontario, Canada.
Anesthesiology. 1990 Dec;73(6):1103-9. doi: 10.1097/00000542-199012000-00006.
This study compared the effects of general and regional anesthesia on cognitive and psychosocial functioning in elderly persons. Sixty-four patients between 60 and 86 yr of age undergoing knee arthroplasty were randomly assigned to receive either general or regional anesthesia. A battery of psychometric tests, including the Satz-Mogel form of the Wechsler Adult Intelligence Scale-Revised, the Wechsler Memory Scale-Revised and the Sickness Impact Profile, and various neuropsychological measures were administered by a blinded observer just before surgery and again 3 months later. Analyses of covariance revealed improvements in most measures that were equivalent between groups. The results indicated that there were no cognitive or psychosocial effects of general or regional anesthesia after 3 months in elderly persons undergoing knee arthroplasty. In this patient population, general anesthesia poses no more risk to long-term mental function than regional anesthesia.
本研究比较了全身麻醉和区域麻醉对老年人认知及心理社会功能的影响。64名年龄在60至86岁之间接受膝关节置换术的患者被随机分配接受全身麻醉或区域麻醉。一组心理测量测试，包括韦氏成人智力量表修订版的萨茨 - 莫格尔形式、韦氏记忆量表修订版和疾病影响概况，以及各种神经心理学测量，在手术前由一名不知情的观察者进行，3个月后再次进行。协方差分析显示，两组在大多数测量指标上的改善情况相当。结果表明，接受膝关节置换术的老年人在3个月后，全身麻醉和区域麻醉对认知或心理社会功能均无影响。在该患者群体中，全身麻醉对长期心理功能造成的风险并不高于区域麻醉。
