Verma Amit Kumar, Haldar Rudrashish, Srivastava Shashi, Das Kuntal Kanti, Mishra Prabhaker
Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
J Neurosci Rural Pract. 2022 Feb 22;13(2):226-235. doi: 10.1055/s-0042-1743443. eCollection 2022 Apr.
Agents like propofol, sevoflurane, and desflurane having rapid revival of psychomotor and cognitive functions translating into reliable anesthetic recovery are chosen for day care procedures. This prospective randomized comparative study was undertaken to compare the psychomotor and cognitive functions of patients undergoing discectomy under different anesthetic strategies. Seventy-five adult American Society of Anesthesiologists grade I and II patients being operated for endoscopic lumbar discectomy under different anesthetic regimens were enrolled and were subjected to Trieger Dot Test (TDT), Digit Symbol Substitution Test (DSST), and Mini-Mental State Examination (MMSE) preoperatively at specified intervals postoperatively. There emergence and early recovery times, complications, and satisfaction levels were also noted. No difference was found in the postoperative TDT and DSST and MMSE scores among the groups at all the time points (15 minutes, 3 minutes, 1 hour, 2 hours, 3 hours, and 4 hours). TDT and DSST demonstrated a tendency to return to baseline by 2nd and 3rd hour postoperatively. Emergence and early recovery times were earlier in the inhalation groups ( 0.005 and 0.007, respectively). Time required to attain a Modified Aldrete Score of 9, complications, and observed side effects were similar among the groups. Patients in the three groups had similar impairments in their psychomotor and cognitive functions which recovered at comparable time periods postoperatively. Emergence and early recovery were, however, faster in the desflurane group.
像丙泊酚、七氟烷和地氟烷这类能使精神运动和认知功能迅速恢复从而实现可靠麻醉苏醒的药物，被选用于日间手术。本前瞻性随机对照研究旨在比较不同麻醉策略下接受椎间盘切除术患者的精神运动和认知功能。招募了75例接受不同麻醉方案下内镜腰椎间盘切除术的美国麻醉医师协会I级和II级成年患者，在术前及术后特定时间间隔接受特里格点试验（TDT）、数字符号替换试验（DSST）和简易精神状态检查表（MMSE）检查。还记录了他们的苏醒和早期恢复时间、并发症及满意度。所有时间点（15分钟、30分钟、1小时、2小时、3小时和4小时）各组术后TDT、DSST和MMSE评分均无差异。TDT和DSST在术后第2小时和第3小时显示出恢复至基线的趋势。吸入组的苏醒和早期恢复时间更早（分别为P<0.005和P<0.007）。达到改良Aldrete评分为9所需时间、并发症及观察到的副作用在各组间相似。三组患者的精神运动和认知功能受损情况相似，术后在相当的时间段内恢复。然而，地氟烷组的苏醒和早期恢复更快。
