帕瑞昔布钠对老年骨科手术患者术后早期认知功能的影响  

Effect of Parecoxib on Postoperative Cognition of Elderly Patients in the Early Phase after Orthopedic Operation

作　　者：金建华[1] 陈亚萍[1] 唐俊[1] 方浩[1] 

机构地区：[1]复旦大学附属金山医院麻醉科,上海201508

出　　处：《中国临床医学》2013年第4期536-537,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨帕瑞昔布钠对老年骨科手术患者术后早期认知功能的影响。方法:将60例择期行骨科手术的老年患者,随机分为帕瑞昔布钠组(P组,n=30)和对照组(C组,n=30)。分别于麻醉诱导前30 min及术后6 h,P组静脉注射帕瑞昔布钠40 mg,C组静脉注射等容量0.9%氯化钠液。术后均采用患者静脉自控镇痛(patient controlled intravenous analgesia,PCIA),镇痛泵内药物为0.001%芬太尼和托烷司琼5 mg,背景剂量为2 mL/h,按压给药量为2 mL/次,锁定时间为15 min,术后48 h停用PCIA泵。记录患者年龄、性别、体质量、受教育年限、手术时间、失血量和认知功能障碍的发生率。于术后24 h、48 h采用视觉模拟评分法(visual analogue scale,VAS)评估疼痛程度;测定患者术前、术后1 d、3 d、7 d的简易精神状态量表(minimental state examination,MMSE)评分。结果:P组和C组分别有6例、7例出现术后认知功能障碍(postoperative cognitive dysfunction,POCD),发生率分别为20%和23.3%(P>0.05)。两组患者术前MMSE评分差异无统计学意义,术后1 d、3 d、7d MMSE评分差异无统计学意义。结论:帕瑞昔布钠未能降低老年骨科手术患者术后早期POCD的发生率。Objective：To observe the effect of parecoxib on postoperative cognition of elderly patients in the early phase after orthopedic operation.Methods：Sixty patients undergoing orthopedic operation were randomly divided into two groups：Group P（n=30）and Group C（n=30）.Half an hour before induction of anesthesia and 6 h after operation,parecoxib（40 mg）was injected intravenously in Group P,and Group C received0.9%sodium chloride solution in the same way.All patients used patient controlled intravenous analgesia（PCIA）pump with fentanyl（0.001%）and tropisetron（5 mg）after operation.The age,sex,weight,degree of education,operation time,blood loss and incidence of cognitive dysfunction were recorded.The intensity of pain was measured by visual analogue scale（VAS）at 24 h、48 h postoperatively.All patients＇ cognitive function were assessed before operation,and 1 d,3 d,7 d after operation by mini-mental state examination（MMSE）.Results：The incidences of postoperative cognitive dysfunction（POCD）were 20%in Group P and 23.3%in Group C（P〉0.05）.The scores of MMSE in Group P were slightly higher than those in group C at 1 d、3 d、7 d after operation（P〉0.05）.Conclusions：Parecoxib has no significant effect on postoperative cognitive function of elderly patients in the early phase after orthopedic operation.

关 键 词：帕瑞昔布钠 认知 老年人 

分 类 号：R614[医药卫生—麻醉学]