两种复合麻醉对老年患者关节镜手术后认知功能及心理应激的影响  

Effects of Two Kinds of Combined Anesthesia on Cognitive Function and Psychological Stress in Elderly Patients after Arthroscopic Surgery

作　　者：肖冬菊 XIAO Dongju(Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院,浙江杭州310016

出　　处：《中国医学创新》2020年第10期81-84,共4页Medical Innovation of China

摘　　要：目的:探讨异丙酚-异氟醚静吸复合全麻与右美托咪定复合七氟醚麻醉对老年患者关节镜手术后认知功能及心理应激的影响。方法:选取2018年1月-2019年1月于本院进行关节镜手术的96例老年患者,根据随机数字表法分为对照组与研究组,每组48例。对照组给予异丙酚-异氟醚静吸复合全身麻醉,研究组给予右美托咪定复合七氟醚麻醉。比较两组麻醉前(T0)、清醒后1 h(T1)、清醒后12 h(T2)、清醒后24 h(T3)时认知功能、心理应激及麻醉满意情况。结果:两组T0时蒙特利尔认知评估量表(MoCA)与状态焦虑量表(SAI)评分比较,差异均无统计学意义(P>0.05)。T1~T3时,研究组MoCA评分均明显高于对照组,而SAI评分均明显低于对照组(P<0.05);研究组麻醉总满意率为97.92%明显高于对照组的79.17%(P<0.05)。结论:右美托咪定复合七氟醚麻醉用于老年患者关节镜手术麻醉效果显著,可加快患者术后认知功能恢复,降低心理应激反应,减少焦虑情绪,提高麻醉满意,值得推广。Objective:To investigate the effects of Propofol-Isoflurane intravenous inhalational combined with general anesthesia and Dexmedetomidine combined with Sevoflurane on cognitive function and psychological stress in elderly patients after arthroscopic surgery.Method:A total of 96 elderly patients underwent arthroscopic surgery in our hospital from January 2018 to January 2019 were selected.According to the random number table method,they were divided into the control group and the research group,48 cases in each group.The control group was given Propofol-Isoflurane intravenous inhalational combined with general anesthesia,and the research group was given Dexmedetomidine combined with Sevoflurane anesthesia.The cognitive function,psychological stress and anesthesia satisfaction of the two groups were compared before anesthesia(T0),1 h after wakefulness(T1),12 h after wakefulness(T2),and 24 h after wakefulness(T3).Result:There were no statistically significant differences between Montreal cognitive assessment scale(MoCA)and state anxiety inventory(SAI)scores at T0 between the two groups(P>0.05).At T1-T3,MoCA scores in the research group were significantly higher than those in the control group,while SAI scores were significantly lower than those in the control group(P<0.05).The total satisfaction rate of anesthesia in the research group was 97.92%significantly higher than 79.17%in the control group(P<0.05).Conclusion:Dexmedetomidine combined with Sevoflurane anesthesia has a significant effect on arthroscopic surgery anesthesia for elderly patients,which can accelerate postoperative cognitive function recovery,reduce psychological stress response,reduce anxiety and improve anesthesia satisfaction.It is worth popularizing.

关 键 词：异丙酚 异氟醚 右美托咪定 七氟醚 认知功能 心理应激 

分 类 号：R614[医药卫生—麻醉学]