【摘要】 目的 探讨术中应用利多卡因对幕上肿瘤切除术患者术后认知功能障碍（postoperative cognitive dysfunction， POCD）的影响。 方法 94例择期行幕上肿瘤切除术的患者，采用随机数字表法分为两组：利多卡因组（L组）46例，全身麻醉诱导后静脉单次注射2%利多卡因1.5 mg/kg，随后以2 mg·kg-1·h-1的速度持续输注至术毕；生理盐水组（N组）48例，按照相同条件给予等容量的生理盐水。由对试验分组不知情的专业神经认知测评师分别在不同时间点对患者进行神经精神认知功能测验，然后判定患者是否发生POCD。 结果 80例患者完成测评，每组分别为40例。① 两组术前各单项认知功能评分比较，差异无统计学意义（P>0.05）。② L组术后1周发生认知功能障碍的比例（15.0%）显著低于N组的发生比例（40.0%）（P<0.05）。③ 两组患者在术后1个月及更长观察时间点POCD的例数比较，差异无统计学意义（P>0.05）。 结论 术中给予利多卡因对于幕上肿瘤切除术的患者术后1周的综合认知功能具有保护作用，对术后及更长时间的POCD影响还有待进一步研究。
【Ａｂｓｔｒａｃｔ】 Ｏｂｊｅｃｔｉｖｅ There was no study on the effect of lidocaine on postoperative cognitive dysfunction （POCD） in patients after supratentorialtumor surgery. Methods Ninety-four patients undergoing elective supratentorial craniotomy were randomly， double-blindly separated into two groups， lidocaine group （L group， n=46）， a dose of lidocaine （2%） was administered as an intravenous bolus （1.5 mg/kg） after induction followed by an intravenous infusion at rate of 2 mg·kg-1·h-1 until the end of surgery， and normal saline group （N group， n=48）， 0.9% saline infusion was given in the same volume at the same rate. Results Eighty patients completed preoperative and postoperative neuropsychological tests. There was no significant difference in each preoperative and postoperative neuropsychological test between groups（P>0.05）. The incidence of POCD at one week after surgery in the L group （15.0%） was significantly lower than that in the N group （40.0%）（P<0.05）. The incidence of POCD at one month or longer after surgery was not significantly different between groups（P>0.05）. Conclusions Lidocaine decreased the incidence of POCD in the patients with supratentorial tumor at one week.
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