关键词: 七氟烷, 吸入浓度, 老年患者, 吸入时间, 认知功能障碍

Abstract: ［Abstract］ Objective To investigate the influence of different concentration and duration ofsevoflurane inhalation anesthesia on postoperative cognitive function in elderly patients undergoing minimally invasive surgery. Methods 128 patients who were scheduled for totally extraperitoneal herniorrhaphy surgery，age 65 to 75 years old，ASA Ⅱ～Ⅲ ，were divided into 4 groups according to the duration and concentration of sevoflurane inhalation：1.5% and ≤1.5 h group（LS group，n=33）， 1.5% and ≥3 h group（LL group，n=30），3% and ≤1.5 h group（HS group，n=34），3% and ≥3 h group （HL group，n=31）. The mini-mental state examination （MMSE） was utilized to assess the cognitive function the day before the surgery and 1 d，7 d，14 d after the surgery. Patients peripheral venous blood samples were collected immediately before the introduction（T0），1 h（T1），6 h（T2）and 24 h（T3）after the operation. The plasma levels of IL?6 and S100? β protein were measured by enzyme? linked immunosorbent assay（ELISA）. Results The difference of MMSE scores in four groups at 1 d， 7 d，14 d after the surgery have no significance（P<0.05）. The incidence rate of cognitive decline in HL group at 7 d after surgery was higher than the other three groups（P<0.05）. Compared with LS group，0.05）. Compared with LL group，the levels of IL? 6 and S100? β protein in HL group at T1 and T2 were significantly higher（P<0.05）. Compared with HS group，the concentrations of IL?6 and S100? β protein in HL group at T1 and T2 were significantly higher （P<0.05）. Conclusion Inhalation of 1.5% sevoflurane combined with remifentanil has little effect on cognitive function in elderly patients after minimally invasive surgery，and has high safety.

Key words: sevoflurane, cognitive function, concentration, duration, elderly patient