| Objective To compare effects on early postoperative cognitive dysfunction after total intravenous anesthesia and analgesia with Remifentanil or fentanyl in elderly patients undergoing the laparoscopic surgeryMethod 64 ASAâ… -â…¡patients (25 males and 39 females) aged≥60 years undergoing the laparoscopic surgery were randomized two groups to receive target-controlled infusion with remifentanil (R group, n= 32) or fentanyl(F group, n= 32). R group was devided into R1 group (n=16), R2 group (n=16) acorrding to with or without PCIA wtih Remifentanil; F group was devided into F1 group (n=16), F2 group (n=16) acorrding to with or without PCIA wtih fentanyl.To assess cognitive function before induction and at 1 day,3 day after operation using Mini-Mental State Examination, and to compare the recovery profiles between groups.Result OAAS score (5=fully conscious, 1=deep sleep) was similar at 30 mins after surgery between R group and F group.Early recovery times (extubation,eyes opening, orientation) was significantly shorter in the R group than that in the F group; VAS score in F group was lower than that in R group at 30 mins after surgery.As compared before the surgery,the MMSE scores were lower at 24h and 72h after surgery in both groups,and the score at postoperative 72h was significant difference between two groups (P＜0.05).There were no significant difference in MMSE score among R1 group and R2 group, F1 group and F2 group, R1 group and F1 group before and after surgery (P>0.05),however,that between R2 group and F2 group has significant difference (P＜0.05)Conclusion Target controlled infusion anesthesia with remifentanil or fentanyl may both induce temporarily postoperative cognitive dysfunction,but recovery of cognitive function is faster,and side effects are less with remifentanil in eldly patients undergiong the laparoscopic surgery.PCIA may have the adverse effect on the recovery of cognitive function...
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