丙泊酚联合瑞芬太尼靶控输注对老年患者髋关节置换术后认知功能的影响  

Effect of Target Controlled Infusion of Propofol plus Remifentanil on Cognitive Function of Elderly Patients after Undergoign Hip SurgeryΔ

作　　者：贺明芳[1] 黄诗栋[1] 罗怡君[1] 

机构地区：[1]深圳市南山区人民医院麻醉科,广东深圳518052

出　　处：《中国医院用药评价与分析》2015年第7期862-863,共2页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2014年南山区科技计划项目(医疗卫生类)立项(No.南科研卫2014032号)

摘　　要：目的：探讨丙泊酚联合瑞芬太尼靶控输注对老年患者髋关节置换术后认知功能的影响。方法：将70例拟行髋关节置换术的老年患者（美国麻醉医师协分级：Ⅱ~Ⅲ级）以随机数字表法分为2组各35例。观察组患者给予丙泊酚联合瑞芬太尼靶控输注麻醉,对照组给予芬太尼联合七氟醚麻醉,观察、统计2组患者术后认知功能障碍发生率、苏醒时间、拔管时间等指标。结果：观察组患者术后自主呼吸恢复时间、苏醒时间、拔管时间均明显短于对照组,差异有统计学意义（P〈0.05）;观察组患者术后3、6 h的简易智能精神状态检查量表评分均低于对照组,差异有统计学意义（P〈0.05）。结论：丙泊酚联合瑞芬太尼靶控输注能缩短老年患者髋关节置换术后的清醒时间,降低认知功能障碍发生率。OBJECTIVE： To investigate the effect of propofol combined with remifentanil（ target controlled infusion） on cognitive function of elderly patients after undergoing hip replacement surgery. METHODS： 70 elderly patients undergoing hip replacement surgery（ ASA Ⅱ-Ⅲ） were randomized to two groups of 35 caes each. The patients in the observation group were given anesthesia using propofol plus remifentanil by target controlled infusion,while those in the control group were given ajestuesia using fentanyl plus sevoflurane. The two groups of patients were followed with regard to incidence of postoperative cognitive dysfunction,postoperative awakenging time and extubation time etc. RESULTS： The time to regain spontaneous breathing,the postoperative awakenging time and the extubation time etc in the observation group were significantly shorter than in the control group（ P〈0. 05）; MMSE（ mini mental state examination） scores at 3 and 6 hours after surgery were significantly lower in the observation group than in the control group（ P〈0. 05）. CONCLUSIONS： Propofol combined with remifentanil by target infusion can shorten the postoperative awakening time and reduce the incidence of cognitive dysfunction in the elderly patients after undergoing hip replacement.

关 键 词：髋关节置换术 丙泊酚 瑞芬太尼 认知功能 

分 类 号：R971[医药卫生—药品]