Objective: To study the effect of propofol used for painless gastroscopy and colonoscopy on psychomotility recovery.
Methods: One hundred adult patients undergoing painless gastroscopy and colonoscopy were recruited, aged 18-72 years, with American Society of Anesthesiologist (ASA) physical status Ⅰ-Ⅱ. According to age, the patients were divided into youth group (20-39 years old, 27 cases), middle age group (40-54 years old, 37 cases), and elder group (55-64 years old, 36 cases). Propofol was continuously infused according to the patients' condition to mantain the bispectal index (BIS) score 55-64. All the patients received psychomotility assesment 30 min before the operations when the discharge criteria were met including number cancellation test, number connection test and board test. The heart rate, blood pressure, saturation of pulse oximetry, electrocardiograph and BIS were monitored during the operation. The operating time, recovery time, total volume of propofol and discharge time were recorded. If the results obtained were inferior to those before operation, a third assessment was taken 30 minutes later until the results recovered or being superior to the baseline levels.
Results: All the patients completed the first and second assessments, and 25 patients had taken the third assessment. There was no statistically significant difference in the results of psychomotility assessment when the patients met the discharge standard. Furthermore, the results were analyzed by grouping with age, and there was no statistical difference in the test results of the youth and middle age groups compared with the preoperative group, among which, the efficiency of the number cancellation test was significantly better than that before operation in the youth group (P < 0.05). However, in the elderly patients the number cancellation efficiency, number connection test and board test were significantly inferior to that before operation (P < 0.05). There was no significant difference in the accuracy of number cancellation compared with that before operation. The patients who needed the third test in the elder group were significantly more than in the other groups (P < 0.05). Compared with the preoperative results, there was no statistical difference in the test results of those who completed the third test.
Conclusion: The psychomotility function of the patients who underwent painless gastroscopy and colonoscopy was recovered when they met discharge criteria. The elderly patients had a prolonged recovery period.
目的: 观察丙泊酚静脉麻醉对无痛胃肠镜检查患者术后精神活动的影响。
方法: 选择100例美国麻醉医师协会(American Society of Anesthesiologist，ASA)Ⅰ~Ⅱ级、年龄18~72岁拟接受择期无痛胃肠镜检查的消化内科患者，将患者分为青年组(20~39岁，27例)、中年组(40~54岁，37例)、老年组(55~64岁，36例)。所有患者采用丙泊酚静脉麻醉，维持脑电双频指数(bispectal index，BIS)值在55~64。麻醉过程中监测心率、血压、脉搏血氧饱和度、心电图及BIS，记录胃肠镜操作时间、苏醒时间、丙泊酚用量、离院时间。术前30 min及满足离院标准时接受数字划消试验、数字连接试验、插板试验测试，如果满足离院标准时三项测试结果未恢复至术前水平，静息30 min后进行第三次测试。
结果: 100例患者均完成了前两次测试，其中25例患者进行了第三次测试。与术前相比，达到离院标准时患者整体的精神活动测试结果差异无统计学意义。进一步按年龄划分后，达到离院标准时，青年组、中年组的数字划消准确率、数字连接时间、插板时间与术前相比差异均无统计学意义，但青年组的数字划消效率术后明显优于术前(P < 0.05)。老年组的数字划消效率、数字连接时间、插板时间都明显劣于术前(P < 0.05)，但数字划消准确率与术前相比差异无统计学意义。老年组中需要进行第三次测试的比例明显高于其他年龄组(P < 0.05)。与术前相比，完成第三次测试者的各项测试结果差异均无统计学意义。
结论: 丙泊酚静脉麻醉下行无痛胃肠镜检查术后患者的精神活动在满足离院标准时已基本恢复，老年患者恢复较慢，但可通过适当延长离院时间得以恢复。
Keywords: Anesthesia recovery period; Colonoscopy; Gastroscopy; Propofol; Psychomotility.