CAJ | 학술논문

目的探讨术中应用利多卡因对幕上肿瘤切除术患者术后认知功能障碍(postoperative cognitive dysfunction,POCD)的影响. 方法 94例择期行幕上肿瘤切除术的患者,采用随机数字表法分为两组:利多卡因组(L组)46例,全身麻醉诱导后静脉单次注射2％利多卡因1.5 mg/kg,随后以2 mg·kg-1·h-1的速度持续输注至术毕;生理盐水组(N组)48例,按照相同条件给予等容量的生理盐水.由对试验分组不知情的专业神经认知测评师分别在不同时间点对患者进行神经精神认知功能测验,然后判定患者是否发生POCD. 结果 80例患者完成测评,每组分别为40例.①两组术前各单项认知功能评分比较,差异无统计学意义(P＞0.05).②L组术后1周发生认知功能障碍的比例(15.0％)显著低于N组的发生比例(40.0％)(P＜0.05).③两组患者在术后1个月及更长观察时间点POCD的例数比较,差异无统计学意义(P＞0.05). 结论术中给予利多卡因对于幕上肿瘤切除术的患者术后1周的综合认知功能具有保护作用,对术后及更长时间的POCD影响还有待进一步研究.
목적 탐토술중응용리다잡인대막상종류절제술환자술후인지공능장애(postoperative cognitive dysfunction,POCD)적영향. 방법 94례택기행막상종류절제술적환자,채용수궤수자표법분위량조:리다잡인조(L조)46례,전신마취유도후정맥단차주사2％리다잡인1.5 mg/kg,수후이2 mg·kg-1·h-1적속도지속수주지술필;생리염수조(N조)48례,안조상동조건급여등용량적생리염수.유대시험분조불지정적전업신경인지측평사분별재불동시간점대환자진행신경정신인지공능측험,연후판정환자시부발생POCD. 결과 80례환자완성측평,매조분별위40례.①량조술전각단항인지공능평분비교,차이무통계학의의(P＞0.05).②L조술후1주발생인지공능장애적비례(15.0％)현저저우N조적발생비례(40.0％)(P＜0.05).③량조환자재술후1개월급경장관찰시간점POCD적례수비교,차이무통계학의의(P＞0.05). 결론 술중급여리다잡인대우막상종류절제술적환자술후1주적종합인지공능구유보호작용,대술후급경장시간적POCD영향환유대진일보연구.
Objective There was no study on the effect of lidocaine on postoperative cognitive dysfunction (POCD) in patients after supratentorialtumor surgery.Methods Ninety-four patients undergoing elective supratentorial craniotomy were randomly,double-blindly separated into two groups,lidocaine group (L group,n=46),a dose of lidocaine (2％) was administered as an intravenous bolus (1.5 mg/kg) after induction followed by an intravenous infusion at rate of 2 mg ·kg-1 ·h-1 until the end of surgery,and normal saline group (N group,n=48),0.9％ saline infusion was given in the same volume at the same rate.Results Eighty patients completed preoperative and postoperative neuropsychological tests.There was no significant difference in each preoperative and postoperative neuropsychological test between groups(P＞0.05).The incidence of POCD at one week after surgery in the L group (15.0％) was significantly lower than that in the N group (40.0％)(P＜0.05).The incidence of POCD at one month or longer after surgery was not significantly different between groups (P＞0.05).Conclusions Lidocaine decreased the incidence of POCD in the patients with supratentorial tumor at one week.