Bocskai Tímea, Karádi Kázmér, Burián András, Kovács Norbert, Bogár Lajos, Lujber László
Pécsi Tudományegyetem, KK, Aneszteziológiai és Intenzív Terápiás Intézet, Pécs.
Pécsi Tudományegyetem, ÁOK, Magatartástudományi Intézet, Pécs.
Ideggyogy Sz. 2016 Jul 30;69(7-8):255-260. doi: 10.18071/isz.69.0255.
Aim of the study - General anesthetics, arterial hypotension and hypoxia developing during anesthesia may result in impaired memory and a decline in other abilities (such as attention, concentration, linguistic and writing abilities). Our aim was to detect changes in cognitive functions due to surgery and anesthesia with controlled arterial hypotension. Materials and methods - We studied combined and intravenous anesthesia detecting pre-and postoperative cognitive functions, intraoperative haemodynamic parameters, demographic data, other data of case history and surgical data. The Montreal Cognitive Assessment test was applied in the randomized, prospective study. The preoperative data served as basis for comparison. The second test was performed following surgery when patients were fully awake. Both groups included 30 patients. Results and conclusion - After both narcosis methods (postoperative second hour) cognitive functions were significantly deteriorated (p<0.05). Median MoCA before sevoflurane anesthesia was 24 points (interquartile range: 22-25), postoperative value was 20 (19-21) (p<0.05). Median MoCA before propofol anesthesia was 24 points (23-26), postoperative value was 20 (18-22) (p<0.01). Intraoperative arterial blood pressure, pulse rate and oxygen saturation values did not correlate with worsening of cognitive function (Pearson correlation coefficient values between -0.19 and 0.42). Execution is influenced by age (negative correlation) and education (positive correlation).
研究目的——全身麻醉、麻醉期间出现的动脉低血压和缺氧可能导致记忆力受损以及其他能力(如注意力、专注力、语言和书写能力)下降。我们的目的是检测因手术和控制性动脉低血压麻醉导致的认知功能变化。材料与方法——我们研究了复合麻醉和静脉麻醉,检测术前和术后的认知功能、术中血流动力学参数、人口统计学数据、其他病史数据和手术数据。在这项随机前瞻性研究中应用了蒙特利尔认知评估测试。术前数据作为比较的基础。第二次测试在患者完全清醒的手术后进行。两组均包括30名患者。结果与结论——两种麻醉方法后(术后第二小时)认知功能均显著恶化(p<0.05)。七氟醚麻醉前蒙特利尔认知评估量表(MoCA)中位数为24分(四分位间距:22 - 25),术后值为20(19 - 21)(p<0.05)。丙泊酚麻醉前MoCA中位数为24分(23 - 26),术后值为20(18 - 22)(p<0.01)。术中动脉血压、脉搏率和血氧饱和度值与认知功能恶化无相关性(皮尔逊相关系数值在 -0.19至0.42之间)。执行力受年龄(负相关)和教育程度(正相关)影响。