The influence of propofol or desflurane on postoperative cognitive dysfunction in patients undergoing coronary artery bypass surgery

被引：106
作者：
Royse, C. F. [1 ,2 ]
Andrews, D. T. [1 ,2 ]
Newman, S. N. [3 ,4 ]
Stygall, J. [3 ,4 ]
Williams, Z. [1 ]
Pang, J. [1 ]
Royse, A. G. [5 ,6 ]
机构：
[1] Univ Melbourne, Anaesthesia & Pain Management Unit, Dept Pharmacol, Carlton, Vic 3053, Australia
[2] Royal Melbourne Hosp, Dept Anaesthesia & Pain Management, Carlton, Vic, Australia
[3] UCL, Behav Med Unit, London WC1E 6BT, England
[4] City Univ London, Fac Hlth Sci, London EC1V 0HB, England
[5] Univ Melbourne, Dept Surg, Melbourne, Vic 3010, Australia
[6] Royal Melbourne Hosp, Dept Cardiac Surg, Melbourne, Vic, Australia
来源：
ANAESTHESIA | 2011年 / 66卷 / 06期
关键词：
K-ATP CHANNELS; CARDIAC-SURGERY; ON-PUMP; NEUROPSYCHOLOGICAL DYSFUNCTION; CARDIOPULMONARY BYPASS; VOLATILE ANESTHETICS; OFF-PUMP; SEVOFLURANE; PROTECTION; OUTCOMES;
D O I：
10.1111/j.1365-2044.2011.06704.x
中图分类号：
R614 [麻醉学];
学科分类号：
100217 ;
摘要：
We investigated the influence of either propofol or desflurane on the incidence of postoperative cognitive dysfunction in a randomised trial of 180 patients undergoing coronary artery bypass surgery. The primary outcome was incidence of postoperative cognitive dysfunction at 3 months, defined as 1 SD deterioration in two or more of 12 neurocognitive tests. Secondary outcomes included early postoperative cognitive dysfunction (between days three and seven), delirium on day one, morbidity and length of hospital stay. Early postoperative cognitive dysfunction was significantly higher with propofol compared with desflurane (56/84 (67.5%) vs 41/83 (49.4%), respectively, p = 0.018), but this effect was not seen at 3 months (10/87 (11.2%) vs 9/90 (10.0%), respectively. There was no difference in delirium (7/89 (7.9%) vs 12/91 (13.2%), respectively, length of hospital stay (median (IQR inverted left perpendicularrangeinverted right perpendicular) 7 (6-9 inverted left perpendicular4-15inverted right perpendicular) vs 6 (5-7 inverted left perpendicular5-16) days, respectively or other morbidities. Desflurane was associated with reduced early cognitive dysfunction.
引用
收藏
页码：455 / 464
页数：10
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