右美托咪定联合七氟醚麻醉对膝关节镜术后老年患者认知功能的影响  

Effect of dexmedetomidine combined with sevoflurane anesthesia on postoperative cognitive function in elderly patients undergoing arthroscopic knee surgery

作　　者：赵军[1] 车向京 ZHAO Jun;CHE Xiang-jing(Department of Anesthesiology,Second Hospital of Qinghuangdao,Hebei Qinghuangdao 066600,China;Department of Cardiology,People's Hospital of Changli,Hebei Qinhuangdao 066600,China)

机构地区：[1]河北省秦皇岛市第二医院麻醉科,河北秦皇岛066600 [2]河北省秦皇岛市昌黎县人民医院心内科,河北秦皇岛066600

出　　处：《中国医刊》2019年第1期76-78,共3页Chinese Journal of Medicine

摘　　要：目的探讨右美托咪定联合七氟醚麻醉对膝关节镜术后老年患者认知功能的影响。方法选取2013年11月至2016年12月在河北省秦皇岛市第二医院行膝关节镜手术的老年患者60例,采用随机数字法分为对照组和观察组,每组30例。入组患者均采用面罩吸入七氟醚联合骶管阻滞麻醉,诱导成功后建立静脉通道,对照组泵入生理盐水,观察组泵入右美托咪定,采用简易智力状态检查表评估两组患者麻醉前后的认知功能状态,采用双抗体放射免疫法测定两组手术前后血清去甲肾上腺素(norepinephrine,NE)、肾上腺素(adrenaline,E)及皮质醇(cortisol,Cor)水平,比较两组麻醉效果及对术后认知功能的影响。结果观察组麻醉后恢复自主呼吸时间、呼之睁眼时间,麻醉后1、6、12小时认知功能状态评分,术后NE、E、Cor水平均低于对照组,差异有显著性(P<0.05)。两组麻醉后并发症发生率比较差异无显著性(P>0.05)。结论右美托咪定联合七氟醚用于老年膝关节镜手术麻醉效果理想,有助于减轻应激反应,改善术后认知功能,值得推广应用。Objective To investigate the effect of dexmedetomidine combined with sevoflurane anesthesia on postoperative cognitive function in elderly patients undergoing arthroscopic surgery.Method From November 2013 to December 2016,60 elderly patients with knee arthroscopy were admitted to the hospital.The random number method was divided into the control group (n=30) and the observation group (n=30).The patients in the group were inhaled sevoflurane combined with sacral block anesthesia with mask inhalation.The venous channel was established after successful induction.The control group was pumped into the normal saline.The observation group was pumped into right metoimidin.The cognitive function state before and after anesthesia was evaluated by the simple intelligence state checklist,and the double antibody radioimmunoassay was used in the two groups.Serum norepinephrine (NE),adrenaline (E)and cortisol (Cor)were determined.The anesthetic effect and postoperative cognitive function of the two groups were compared.Result After anesthesia,the observation group recovered the time of breathing and the time of eye opening.The scores of 1H,6h and 12h cognitive function were lower than .those of the control group (P<0.05).The incidence of complications after anesthesia was not statistically significant (P >0.05)in the two groups.Conclusion The effect of sevoflurane combined with right metoimidin in the elderly patients under knee arthroscopy is ideal,which is helpful,to improve the postoperative-cognitive function and stress response.It is worth popularizing.

关 键 词：右美托咪定 膝关节镜手术 认知功能 应激反应 

分 类 号：R614.4[医药卫生—麻醉学] R687.4[医药卫生—外科学]