PDF(Pubmed)
Abstract：
UNASSIGNED: Following aneurysmal subarachnoid hemorrhage, 40-50% of survivors experience cognitive dysfunction, which affects their quality of life. Anesthetic agents play a pivotal role in aneurysm surgeries. However, substantial evidence regarding their effects on neurocognitive function is lacking. This study evaluated the effects of propofol and desflurane on postoperative neurocognitive function and serum S-100B levels.
UNASSIGNED: One hundred patients were equally randomized to receive either propofol (Group P) or desflurane (Group D). Cognitive function was assessed using the Montreal Cognitive Assessment scale at three different time points: Preoperatively, at the time of discharge, and one month after surgery. Perioperative serum levels of S-100B were also measured.
UNASSIGNED: The preoperative mean cognitive score in Group P was 21.64 + 4.46 and in Group D was 21.66 + 4.07 (P = 0.79). At discharge, a significant decrease in cognitive scores was observed compared to preoperative scores (Group P- 20.91 + 3.94, P = 0.03 and Group D-19.28 + 4.22, P = 0.00); however, scores were comparable between the two groups (P = 0.09). One month following surgery, mean cognitive scores were 22.63 + 3.57 in Group P and 20.74 + 3.89 in Group D, and the difference was significant (P = 0.04). Higher memory and orientation scores were observed in Group P than in Group D at one month (P < 0.05) in the subgroup analysis. Both groups had similar serum S-100B levels.
UNASSIGNED: The mean cognitive scores one month after surgery improved significantly with propofol compared with desflurane, but without clinical significance. Individual domain analysis demonstrated that orientation and memory scores were better preserved with propofol.
UNASSIGNED: One hundred patients were equally randomized to receive either propofol (Group P) or desflurane (Group D). Cognitive function was assessed using the Montreal Cognitive Assessment scale at three different time points: Preoperatively, at the time of discharge, and one month after surgery. Perioperative serum levels of S-100B were also measured.
UNASSIGNED: The preoperative mean cognitive score in Group P was 21.64 + 4.46 and in Group D was 21.66 + 4.07 (P = 0.79). At discharge, a significant decrease in cognitive scores was observed compared to preoperative scores (Group P- 20.91 + 3.94, P = 0.03 and Group D-19.28 + 4.22, P = 0.00); however, scores were comparable between the two groups (P = 0.09). One month following surgery, mean cognitive scores were 22.63 + 3.57 in Group P and 20.74 + 3.89 in Group D, and the difference was significant (P = 0.04). Higher memory and orientation scores were observed in Group P than in Group D at one month (P < 0.05) in the subgroup analysis. Both groups had similar serum S-100B levels.
UNASSIGNED: The mean cognitive scores one month after surgery improved significantly with propofol compared with desflurane, but without clinical significance. Individual domain analysis demonstrated that orientation and memory scores were better preserved with propofol.
摘要：
■动脉瘤性蛛网膜下腔出血后，40-50%的幸存者经历认知功能障碍，影响他们的生活质量。麻醉剂在动脉瘤手术中起关键作用。然而,缺乏关于它们对神经认知功能影响的大量证据。本研究评估了异丙酚和地氟醚对术后神经认知功能和血清S-100B水平的影响。
■100名患者被随机分为异丙酚（P组）或地氟醚（D组）。在三个不同的时间点使用蒙特利尔认知评估量表评估认知功能：术前，在出院时，手术后一个月.还测量了围手术期的S-100B血清水平。
■术前平均认知评分P组为21.64±4.46，D组为21.66±4.07（P=0.79）。出院时,与术前评分相比,认知评分显著下降(P-20.91+3.94,P=0.03,D-19.28+4.22,P=0.00);两组评分具有可比性(P=0.09)。手术后一个月,P组的平均认知评分为22.63+3.57，D组的平均认知评分为20.74+3.89，差异有统计学意义(P=0.04)。在亚组分析中，P组在1个月时的记忆和定向得分高于D组（P<0.05）。两组血清S-100B水平相似。
■与地氟醚相比，丙泊酚术后1个月的平均认知评分明显改善，但没有临床意义.个体域分析表明，异丙酚可以更好地保留定向和记忆评分。
■100名患者被随机分为异丙酚（P组）或地氟醚（D组）。在三个不同的时间点使用蒙特利尔认知评估量表评估认知功能：术前，在出院时，手术后一个月.还测量了围手术期的S-100B血清水平。
■术前平均认知评分P组为21.64±4.46，D组为21.66±4.07（P=0.79）。出院时,与术前评分相比,认知评分显著下降(P-20.91+3.94,P=0.03,D-19.28+4.22,P=0.00);两组评分具有可比性(P=0.09)。手术后一个月,P组的平均认知评分为22.63+3.57，D组的平均认知评分为20.74+3.89，差异有统计学意义(P=0.04)。在亚组分析中，P组在1个月时的记忆和定向得分高于D组（P<0.05）。两组血清S-100B水平相似。
■与地氟醚相比，丙泊酚术后1个月的平均认知评分明显改善，但没有临床意义.个体域分析表明，异丙酚可以更好地保留定向和记忆评分。
