Objective:To explore the influence of patient-controlled intravenous analgesia(PCIA)with morphine on early post-operative cognitive function in the elderly patients undergoing abdominal surgery with target control infusion(TCI)/total intra-venous anesthesia(TIVA).Methods:A total of 120 patients matched with the inclusion criteria were randomly divided into PCIA group with morphine(n=60)and control group(n=60).All the patients underwent abdominal operation with TCI/TI-VA.Pain intensity at 24 h and 48 h after the operation were evaluated by visual analogue scale(VAS).Mini-mental state examination(MMSE)scores were recorded at 24 h before the operation and 24 h,48 h,72 h after the operation,in order to as-sess cognitive function and incidence of POCD.Results:Scores of VAS in PCIA group were significantly lower than those in control group at 24 h and 48 h after the operation(P <0.01).The incidence of postoperative cognitive dysfunction(POCD)at 72 h after the operation in PCIA group was lower than that in the control group (P <0.05),and recovery of postoperative cog-nitive function in PCIA group was better than that in the control group(P <0.05).Conclusions:PCIA with morphine could re-duce the incidence of POCD in the elderly patients undergoing abdominal surgery and improve postoperative cognitive function.%目的：探讨吗啡静脉自控镇痛（patient-controlled intravenous analgesia，PCIA）对老年患者在靶控输注（target control in-fusion，TCI）全凭静脉麻醉（total intravenous anesthesia，TIVA）下行腹部手术后早期认知功能的影响。方法：120例符合入选标准的老年患者随机分为吗啡 PCIA 组和对照组，每组60例。两组患者均在 TCI／TIVA 下行腹部手术，均于术后24 h、48 h进行疼痛视觉模拟评分（visual analogue scale，VAS）；术前24 h 及术后24 h、48 h、72 h 用简易精神状态量表（mini-mental state examination，MMSE）行神经心理学检查，评价认知功能；记录术后认知功能障碍（postoperative cognitive dysfunction，POCD）发生率。结果：术后24 h 和48 h PCIA 组 VAS 评分显著低于对照组（P ＜0．01）；术后72 h PCIA 组 POCD 发生率低于对照组（P ＜0．05），且术后认知功能恢复情况优于对照组（P ＜0．05）。结论：吗啡 PCIA 可减少老年患者在 TCI／TNA 下行腹部手术后 POCD 的发生，并促进术后认知功能的恢复。
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