右美托嘧啶对老年腹腔镜胆囊切除术患者麻醉效果及认知功能的影响  

Effects of Dexmedetomidine on Anesthesia and Cognitive Function in Elderly Patients Undergoing Laparoscopic Cholecystectomy

作　　者：乔克坤 李向[1] QIAO Kekun;LI Xiang(Department of Anesthesiology,Tianmen First People's Hospital,Tianmen Hubei 431700,China)

机构地区：[1]天门市第一人民医院麻醉科

出　　处：《中国药物警戒》2020年第2期81-86,共6页Chinese Journal of Pharmacovigilance

摘　　要：目的探讨右美托嘧啶对老年腹腔镜胆囊切除术患者麻醉效果及认知功能的影响。方法选取老年腹腔镜胆囊切除术患者100例,依据随机数字表分为A组和B组,每组50例。A组给予常规全麻处理,B组在此基础上给予右美托嘧啶处理。比较两组血流动力学、麻醉效果、全麻用药量、认知功能、不良反应情况。结果B组麻醉10 min时(T1)、胆囊切除时(T2)和术毕(T3)的平均动脉压、心率和脑电双频指数明显低于A组,有统计学差异(P<0.05);B组全麻用药量、认知功能障碍发生率明显低于A组;B组术后12、24、72 h的简易精神状况检查量表评分明显高于A组,有统计学差异(P<0.05);A组和B组不良反应发生率比较,无统计学差异(P>0.05)。结论右美托嘧啶可有效改善老年腹腔镜胆囊切除术患者血流动力学及麻醉效果,有利于减少全麻用药量及认知功能障碍发生,且安全性好,值得临床推广。Objective To study the effect of dexmedetomidine on anesthesia and cognitive functions in elderly patients undergoing laparoscopic cholecystectomy.Methods A total of 100 elderly patients undergoing laparoscopic cholecystectomy in our hospital between March 2017 and March 2019 were selected,who were equally divided into group A and group B using the random number table method.Group A received general anesthesia while group B was additionally given dexmedetomidine.The hemodynamics[mean arterial pressure(MAP),heart rate(HR)],anesthesia effect[bispectral index(BIS)],general anesthesia dosage,cognitive function[mini-mental state examination scale(MMSE)]and adverse reactions were compared between the two groups.Results The MAP,HR and BIS in group B 10 minutes into anesthesia(T1),during cholecystectomy(T2),and post-operatively(T3)were significantly lower than those in group A,and the difference was statistically significant(P<0.05).The dosage of general anesthesia and the incidence of cognitive impairment in group B were significantly lower than those in group A,while the MMSE scores in group B at 12,24 and 72 h after operation were significantly higher than those in group A,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Dexmedetomidine can effectively improve the hemodynamics and anesthesia effect of elderly patients undergoing laparoscopic cholecystectomy,thus helping to reduce the dosage of general anesthesia and cognitive impairment.It is safe and should be made more accessible.

关 键 词：右美托嘧啶 全麻 老年 腹腔镜胆囊切除术 麻醉效果 认知功能 

分 类 号：R969[医药卫生—药理学]