Riis J, Lomholt B, Haxholdt O, Kehlet H, Valentin N, Danielsen U, Dyrberg V
Acta Anaesthesiol Scand. 1983 Feb;27(1):44-9. doi: 10.1111/j.1399-6576.1983.tb01903.x.
The postoperative course of mental performance during the first week and at 3 months after operation was studied in 30 patients above the age of 60, undergoing total hip replacement arthroplasty. The patients were randomly allocated to receive either general anesthesia, epidural analgesia, or general anesthesia plus epidural analgesia. The surgically induced increase in plasma cortisol and glucose was inhibited in the two groups receiving epidural analgesia. Mental performance was studied with psychological methods. An equal degree of postoperative impairment of mental performance of 3-4 days' duration was found in all groups. Three months after surgery, mental function had improved slightly and to the same extent in all groups. We conclude that the after surgery, mental function had improved slightly and to the same extent in all groups. We conclude that the transient mental impairment occurring within the first postoperative week is caused by factors other than general anesthetic agents and the endocrine-metabolic response to surgery.
对30例60岁以上接受全髋关节置换术的患者，研究了术后第一周及术后3个月的精神表现过程。患者被随机分配接受全身麻醉、硬膜外镇痛或全身麻醉加硬膜外镇痛。接受硬膜外镇痛的两组中，手术引起的血浆皮质醇和葡萄糖升高受到抑制。采用心理学方法研究精神表现。所有组均发现有持续3 - 4天的同等程度的术后精神表现损害。术后3个月，所有组的精神功能均有轻微改善且程度相同。我们得出结论，术后第一周内出现的短暂精神损害是由全身麻醉剂和手术的内分泌 - 代谢反应以外的因素引起的。
