全身麻醉药物与手术后认知功能障碍_West China Medical Journal

Authors：

周裕凯 ¹ ,  张兰 ²

Corresponding author：

张兰, Email: christianziege17@163.com

Keywords：

吸入麻醉药; 静脉麻醉药; 手术后认知功能障碍

Video：

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全身麻醉药物被认为是造成手术后认知功能障碍的重要因素之一，前期实验大都是推理性和描述性的，样本规模小，不能充分说明两者间的关系。为今后从大脑神经元形态学和神经生物学研究方面获得突破，现从吸入麻醉药、静脉麻醉药各自对认知功能的影响和可能机制，以及不同麻醉药的比较等方面进行综述。

Citation： 周裕凯,张兰. 全身麻醉药物与手术后认知功能障碍. West China Medical Journal, 2012, 27(10): 1588-1590. doi: Copy

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2.	Moller JT, Cluitmans P, Rasmussen LS, et al. Long-term postoperative congnitive dysfunction in the elderly: ISPOCD1 study [J]. Lancet, 1998, 351(9106): 857-861.
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14.	Morgan CJ, Mofeez A, Brandner B, et al. Ketamine impairs response inhibition and is positively reinforcing in healthy volunteers: a dose-response study [J]. Psychopharmacology, 2004, 172(3): 298-308.
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16.	Lee IH, Culley DJ, Baxter MG, et al. Spatial memory is intact in aged rats after propofol anesthesia [J]. Anesthesia Analgesia, 2008, 107(4): 1211-1215.
17.	Seidl S, Hausmann R, Neisser J, et al. Severity and duration of mental deficiency symptoms after intravenous administration of propofol [J]. Int J Legal Med, 2007, 121(4): 281-285.
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19.	Murphy SE, Downham C, Cowen PJ, et al. Direct effects of diazepam on emotional processing in healthy volunteers [J]. Psychopharmacology, 2008, 199(4): 503-513.
20.	Rasmussen LS, Steentoft A, Rasmussen H, et al. Benzodiazepines and postoperative cognitive dysfunction in the elderly. ISPOCD Group. International study of postoperrative cognitive dysfunction [J]. Br J Anaesth, 1999, 83(4 ): 585-589.
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1. 　Bedford PD. Adverse cerebral effects of anaesthesia on old people [J]. Lancet, 1955, 269(6884): 259-263.
2. 　Moller JT, Cluitmans P, Rasmussen LS, et al. Long-term postoperative congnitive dysfunction in the elderly: ISPOCD1 study [J]. Lancet, 1998, 351(9106): 857-861.
3. 　Bitsch M, Foss N, Kristensen B, et al. Pathogenesis of and management strategies for postoperative delirium after hipfracture [J]. Acta Orthopaedica Scandinavica, 2004, 75(4): 378-389.
4. 　Abildstrom H, Rasmussen LS, Rentowl P, et al. Cognitive dysfunction 1-2 years after non-cardiac surgery in the elderly. International study of post-operative cognitive dysfunction [J]. Acta Anaesthesiol Scandinavica, 2000, 44(10): 1246-1251.
5. 　Billig N, Stockton P, Cohen-Mansfield J, et al. Cognitive and affective changes after cataract surgery in an elderly population [J]. Am J Geria Psychiat, 1996, 4(1): 29-38.
6. 　Culley DJ, Baxter MG, Yukhananov R, et al. Long-term impairment of acquisition of a spatial memory task following isoflurane-nitrous oxide anesthesia in rats [J]. Anesthesiology, 2004, 100(2): 309-314.
7. 　Chen X, Zhao M, White PF , et al. The recovery of cognitive function after general anesthesia in elderly patients: a comparison of desflurane and sevoflurane [J]. Anesthesia Analgesia, 2001, 93(6): 1489-1494.
8. 　Levin ED, Bradley A, Addy N, et al. Hippocampal α7 and α4β2 nicotinic receptors and working memory [J]. Neuroscience, 2002, 109(4): 757-765.
9. 　Simon W, Hapfelmeier G, Kochs E, et al. Isoflurane blocks synaptic plasticity in the mouse hippocampus [J]. Anesthesiology, 2001, 94(4): 1058-1065.
10. 　Eckenhoff RG, Johansson JS, Wei H, et al. Inhaled anesthetic enhancement of amyloid-beta oligomerization and cytotoxicity [J]. Anesthesiology, 2004, 101(3): 703-709.
11. 　Wei H, Kang B, Wei W, et al. Isoflurane and sevoflurane affect cell survival and BCL-2/BAX ratio differently [J]. Brain Res, 2005, 1037(1/2): 139-147.
12. 　Bekker A, Shah R, Quartermain D, et al. Isoflurane preserves spatial working memory in adult mice after moderate hypoxia [J]. Anesthesia Analgesia, 2006, 102(4): 1134-1138.
13. 　王贤裕, 田玉科, 杨辉, 等. 腹腔重复注射小剂量氯胺酮术后镇痛对趾部切口术大鼠认知功能的影响 [J]. 中华麻醉学杂志, 2005, 25(3): 205-207.
14. 　Morgan CJ, Mofeez A, Brandner B, et al. Ketamine impairs response inhibition and is positively reinforcing in healthy volunteers: a dose-response study [J]. Psychopharmacology, 2004, 172(3): 298-308.
15. 　Rowland LM, Astur RS, Jung RE, et al. Selective cognitive impairments associated with nmda receptor blockade in humans [J]. Neuropsychopharmacology, 2005, 30(3): 633-639.
16. 　Lee IH, Culley DJ, Baxter MG, et al. Spatial memory is intact in aged rats after propofol anesthesia [J]. Anesthesia Analgesia, 2008, 107(4): 1211-1215.
17. 　Seidl S, Hausmann R, Neisser J, et al. Severity and duration of mental deficiency symptoms after intravenous administration of propofol [J]. Int J Legal Med, 2007, 121(4): 281-285.
18. 　Dowd NP, Karski JM, Cheng DC, et al. Fast-track cardiac anaesthesia in the elderly: effect of two different anaesthetic techniques on mental recovery [J]. Br J Anaesth, 2001, 86(1): 68-76.
19. 　Murphy SE, Downham C, Cowen PJ, et al. Direct effects of diazepam on emotional processing in healthy volunteers [J]. Psychopharmacology, 2008, 199(4): 503-513.
20. 　Rasmussen LS, Steentoft A, Rasmussen H, et al. Benzodiazepines and postoperative cognitive dysfunction in the elderly. ISPOCD Group. International study of postoperrative cognitive dysfunction [J]. Br J Anaesth, 1999, 83(4 ): 585-589.
21. 　Dixon CE, Ma XC, Kline AE, et al. Acute etomidate treatment reduces cognitive deficits and histopathology in rats with traumatic brain injury [J]. Critical care medicine, 2003, 31(8): 2222-2227.
22. 　Sabatowski R, Schwalen S, Rettig K, et al. Driving ability under long-term treatment with transdermal fentanyl [J]. J Pain Symptom Manage, 2003, 25(1): 38-47.
23. 　Silbert BS, Scott DA, Evered LA, et al. A comparison of the effect of high- and low-dose fentanyl on the incidence of postoperative cognitive dysfunction after coronary artery bypass surgery in the elderly [J]. Anesthesiology, 2006, 104(6): 1137-1145.
24. 　Jindal R, Kumra VP, Naranl KK, et al. Comparison of maintenance and emergence characteristics after desflurane or sevoflurane in outpatient anaesthesia [J]. Indian J Anaesth, 2011, 55(1): 36-42.
25. 　Larsen B, Seitz A, Larsen R. Recovery of cognitive function after remifentanil-propofol anesthesia: a comparison with desflurane and sevoflurane anesthesia [J]. Anesthesia Analgesia, 2000, 90(1): 168-174.
26. 　Munte S, Munte TF, Kuche H, et al. General anesthesia for interventional neuroradiology: propofol versus isoflurane [J]. J Clin Anesth, 2001, 13(3): 186-192.

West China Medical Journal

全身麻醉药物与手术后认知功能障碍

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