不同麻醉方式对眼科手术患者认知功能影响的比较分析

IF 1.8 4区 医学 Q3 OPHTHALMOLOGY Journal of Ophthalmology Pub Date : 2023-04-25 DOI:10.31288/oftalmolzh202322125
Олена Алексєєва, Г. С. Дорофєєва, В. П. Алексєєв, І. А. Драпак
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引用次数: 0

摘要

背景:麻醉师不仅要将患者的生命作为一个过程来挽救,而且要使患者在术后恢复他/她的社交生活,因为患者寿命延长,一生中社交活动频繁,日常生活中技术设备的使用增加。目的:评估穿透性角膜移植术患者中枢神经系统(CNS)的变化,以优化麻醉技术的选择,同时考虑全身麻醉对术后认知功能的影响。材料与方法:采用简易精神状态检查(MMSE)、额叶评估测试(FAB)、Luria试验等神经心理测试,分别于术前、术后6小时、24小时、7天、21天检测患者的认知功能。结果:在比较分析不同麻醉方式对穿透性角膜移植术患者认知功能影响的基础上,我们得出区域麻醉(翼状腭窝阻滞)、右美托咪定输注(0.3µg/kg)和全身镇痛(维持在氧/七氟醚混合物中)联合排除0.5%西巴松对认知功能的影响最短,影响最不深远。结论:在比较分析不同麻醉方式对穿透性角膜移植术患者认知功能影响的基础上,我们得出区域麻醉(翼腭窝阻滞)、右美托咪定输注(0.3µg/kg)和全身镇痛(维持在氧/七氟醚混合物中),在用药前去除0.5%的西巴松,麻醉期间减少芬太尼的用量,对接受眼科手术的患者的认知状态的影响最短(平均持续时间为一天),影响最小。
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Comparative analysis of the impact of selected anesthesia methods on the cognitive function of patients undergoing ophthalmic surgery
Background: Anesthesiologists should not only save patient’s life as a process, but also enable the patient to recover his/her social life after surgery, given increased longevity, high social activity throughout life, and increased use of technical equipment in everyday life. Purpose: To assess central nervous system (CNS) changes in patients undergoing penetrating keratoplasty in order to optimize the choice of anesthesia technique, while taking into account the impact of general anesthesia on postoperative cognitive functions. Material and Methods: We employed neuropsychological tests such as Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) and Luria’s test to examine the cognitive function of patients before surgery and 6 hours, 24 hours, 7 days and 21 days after surgery. Results: On the basis of comparative analysis of the impact of selected anesthesia methods on cognitive function of patients undergoing surgery (penetrating keratoplasty), we concluded that a combination of regional anesthesia (pterygopalatine fossa blockade), dexmedetomidine infusion (0.3 µg/kg) and general analgesia (maintenance in an oxygen/sevoflurane mixture) with exclusion of Sibazon 0.5% had the shortest and the least profound impact on the cognitive function. Conclusion: On the basis of comparative analysis of the impact of selected anesthesia methods on cognitive function of patients undergoing penetrating keratoplasty, we concluded that a combination of regional anesthesia (pterygopalatine fossa blockade), dexmedetomidine infusion (0.3 µg/kg) and general analgesia (maintenance in an oxygen/sevoflurane mixture) with removal of Sibazon 0.5% from premedication and presence of a reduced amount of fentanyl used during anesthesia had the shortest (with a mean duration of a day) and the least profound impact on cognitive state in patients undergoing ophthalmic surgery.
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来源期刊
Journal of Ophthalmology
Journal of Ophthalmology MEDICINE, RESEARCH & EXPERIMENTAL-OPHTHALMOLOGY
CiteScore
4.30
自引率
5.30%
发文量
194
审稿时长
6-12 weeks
期刊介绍: Journal of Ophthalmology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the anatomy, physiology and diseases of the eye. Submissions should focus on new diagnostic and surgical techniques, instrument and therapy updates, as well as clinical trials and research findings.
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