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Br J Anaesth：全麻不影响术后神经认知功能障碍的发生

2014-11-24 佚名 中国医学论坛报

椎管内麻醉全麻术后神经认知功能障碍
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澳大利亚学者进行的一项前瞻性随机对照研究表明，全身麻醉与椎管内麻醉相比不增加术后认知功能障碍(POCD)的发生率，这提示POCD的发生可能和手术或者手术流程有关。论文发表于《英国麻醉学杂志》。 研究者筛查了2005～2011年间的2706例患者，其中符合入组标准的患者100例，在进行体外冲击波碎石术时被随机分组分别接受全麻和椎管内麻醉，在术前、术后第7天、术后3个月进行一组8项神经认知测

澳大利亚学者进行的一项前瞻性随机对照研究表明，全身麻醉与椎管内麻醉相比不增加术后认知功能障碍(POCD)的发生率，这提示POCD的发生可能和手术或者手术流程有关。论文发表于《英国麻醉学杂志》。

研究者筛查了2005～2011年间的2706例患者，其中符合入组标准的患者100例，在进行体外冲击波碎石术时被随机分组分别接受全麻和椎管内麻醉，在术前、术后第7天、术后3个月进行一组8项神经认知测试，计算POCD的发生率并通过意向处理分析比较两组间POCD发生率。

结果为，50例患者接受全麻，48例患者接受椎管内麻醉并且不使用镇静类或者术后阿片类药物。术后3个月时，6.8%的全麻组和19.6%的椎管内麻醉组患者中发现POCD[95%可信区间(CI)为1.4%～18.7%和9.4%～33.9%，P=0.07];术后第7天时，全麻和蛛网膜下腔麻醉组患者的POCD发生率分别为4.1%(95%CI为0.5%～14%)和11.9%(95%CI为4.0%～26.6%，P=0.16)。

原始出处：

Silbert BS1, Evered LA2, Scott DA2.Incidence of postoperative cognitive dysfunction after general or spinal anaesthesia for extracorporeal shock wave lithotripsy.Br J Anaesth. 2014 Nov;113(5):784-91. doi: 10.1093/bja/aeu163. Epub 2014 Jun 27.

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    2015-12-26 hixiaoluo

    这个有争议

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  2. [GetPortalCommentsPageByObjectIdResponse(id=48020, encodeId=1c12480206c, content=这个有争议, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 14:28:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633310, encodeId=edde163331015, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Wed Feb 04 21:08:00 CST 2015, time=2015-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050425, encodeId=ab5c205042571, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 13 10:08:00 CST 2015, time=2015-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1801964, encodeId=ea4018019646f, content=<a href='/topic/show?id=47ffe4559e1' target=_blank style='color:#2F92EE;'>#神经认知功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74559, encryptionId=47ffe4559e1, topicName=神经认知功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512d422, createdName=canlab, createdTime=Tue Jun 16 14:08:00 CST 2015, time=2015-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421013, encodeId=dae114210134f, content=<a href='/topic/show?id=09d33294eb8' target=_blank style='color:#2F92EE;'>#功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32947, encryptionId=09d33294eb8, topicName=功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b3493649807, createdName=naiwu78, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476532, encodeId=ac4114e6532f5, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603509, encodeId=7ac4160350901, content=<a href='/topic/show?id=ef43e455710' target=_blank style='color:#2F92EE;'>#神经认知#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74557, encryptionId=ef43e455710, topicName=神经认知)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e6519038657, createdName=szhvet, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=)]
    2015-02-04 AspirantSuo

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  3. [GetPortalCommentsPageByObjectIdResponse(id=48020, encodeId=1c12480206c, content=这个有争议, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 14:28:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633310, encodeId=edde163331015, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Wed Feb 04 21:08:00 CST 2015, time=2015-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050425, encodeId=ab5c205042571, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 13 10:08:00 CST 2015, time=2015-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1801964, encodeId=ea4018019646f, content=<a href='/topic/show?id=47ffe4559e1' target=_blank style='color:#2F92EE;'>#神经认知功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74559, encryptionId=47ffe4559e1, topicName=神经认知功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512d422, createdName=canlab, createdTime=Tue Jun 16 14:08:00 CST 2015, time=2015-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421013, encodeId=dae114210134f, content=<a href='/topic/show?id=09d33294eb8' target=_blank style='color:#2F92EE;'>#功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32947, encryptionId=09d33294eb8, topicName=功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b3493649807, createdName=naiwu78, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476532, encodeId=ac4114e6532f5, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603509, encodeId=7ac4160350901, content=<a href='/topic/show?id=ef43e455710' target=_blank style='color:#2F92EE;'>#神经认知#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74557, encryptionId=ef43e455710, topicName=神经认知)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e6519038657, createdName=szhvet, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=)]
    2015-08-13 xiangyuzhou971

    #EST#

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    2015-06-16 canlab

    #神经认知功能障碍#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=48020, encodeId=1c12480206c, content=这个有争议, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 14:28:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633310, encodeId=edde163331015, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Wed Feb 04 21:08:00 CST 2015, time=2015-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050425, encodeId=ab5c205042571, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 13 10:08:00 CST 2015, time=2015-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1801964, encodeId=ea4018019646f, content=<a href='/topic/show?id=47ffe4559e1' target=_blank style='color:#2F92EE;'>#神经认知功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74559, encryptionId=47ffe4559e1, topicName=神经认知功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512d422, createdName=canlab, createdTime=Tue Jun 16 14:08:00 CST 2015, time=2015-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421013, encodeId=dae114210134f, content=<a href='/topic/show?id=09d33294eb8' target=_blank style='color:#2F92EE;'>#功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32947, encryptionId=09d33294eb8, topicName=功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b3493649807, createdName=naiwu78, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476532, encodeId=ac4114e6532f5, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603509, encodeId=7ac4160350901, content=<a href='/topic/show?id=ef43e455710' target=_blank style='color:#2F92EE;'>#神经认知#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74557, encryptionId=ef43e455710, topicName=神经认知)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e6519038657, createdName=szhvet, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=)]
    2014-11-26 naiwu78

    #功能障碍#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=48020, encodeId=1c12480206c, content=这个有争议, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 14:28:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633310, encodeId=edde163331015, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Wed Feb 04 21:08:00 CST 2015, time=2015-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050425, encodeId=ab5c205042571, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 13 10:08:00 CST 2015, time=2015-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1801964, encodeId=ea4018019646f, content=<a href='/topic/show?id=47ffe4559e1' target=_blank style='color:#2F92EE;'>#神经认知功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74559, encryptionId=47ffe4559e1, topicName=神经认知功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512d422, createdName=canlab, createdTime=Tue Jun 16 14:08:00 CST 2015, time=2015-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421013, encodeId=dae114210134f, content=<a href='/topic/show?id=09d33294eb8' target=_blank style='color:#2F92EE;'>#功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32947, encryptionId=09d33294eb8, topicName=功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b3493649807, createdName=naiwu78, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476532, encodeId=ac4114e6532f5, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603509, encodeId=7ac4160350901, content=<a href='/topic/show?id=ef43e455710' target=_blank style='color:#2F92EE;'>#神经认知#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74557, encryptionId=ef43e455710, topicName=神经认知)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e6519038657, createdName=szhvet, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=)]
    2014-11-26 柳叶一刀

    #全麻#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=48020, encodeId=1c12480206c, content=这个有争议, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 14:28:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633310, encodeId=edde163331015, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Wed Feb 04 21:08:00 CST 2015, time=2015-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050425, encodeId=ab5c205042571, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 13 10:08:00 CST 2015, time=2015-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1801964, encodeId=ea4018019646f, content=<a href='/topic/show?id=47ffe4559e1' target=_blank style='color:#2F92EE;'>#神经认知功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74559, encryptionId=47ffe4559e1, topicName=神经认知功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512d422, createdName=canlab, createdTime=Tue Jun 16 14:08:00 CST 2015, time=2015-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421013, encodeId=dae114210134f, content=<a href='/topic/show?id=09d33294eb8' target=_blank style='color:#2F92EE;'>#功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32947, encryptionId=09d33294eb8, topicName=功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b3493649807, createdName=naiwu78, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476532, encodeId=ac4114e6532f5, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603509, encodeId=7ac4160350901, content=<a href='/topic/show?id=ef43e455710' target=_blank style='color:#2F92EE;'>#神经认知#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74557, encryptionId=ef43e455710, topicName=神经认知)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e6519038657, createdName=szhvet, createdTime=Wed Nov 26 04:08:00 CST 2014, time=2014-11-26, status=1, ipAttribution=)]
    2014-11-26 szhvet

    #神经认知#

    0

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