舒芬太尼对老年髋关节置换术患者脑氧饱和度及术后认知功能的影响  

Effects of sufentanil on cerebral oxygen saturation and postoperative cognitive function in elderly patients undergoing hip joint replacement

作　　者：王凯[1] 姜维[1] 陈亮[1] 何文胜[1] 张军[1] Wang Kai;Jiang Wei;Chen Liang;He Wen-sheng;Zhang Jun(The Second People’s Hospital of Hefei,Hefei 230011,China)

机构地区：[1]合肥市第二人民医院,合肥230011

出　　处：《湖南师范大学学报（医学版）》2021年第2期229-232,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:探讨舒芬太尼对老年髋关节置换术患者脑氧饱和度(SctO_(2))及术后认知功能(POCD)的影响。方法:在2016年9月~2019年8月期间,88例接受全麻下行髋关节置换手术的65岁以上患者随机分为2组:舒芬太尼组和芬太尼组。记录各组麻醉恢复时间、镇静水平、手术期间SctO_(2)变化以及POCD发生情况。结果:舒芬太尼组的麻醉恢复时间明显低于芬太尼组,并且在拔管后5、10、30、60 min的VAS评分均显著低于芬太尼组,而在拔管后5、10min的Ramsay评分显著高于芬太尼组。与芬太尼组相比,舒芬太尼组手术期间的平均SctO_(2)(73.9±1.5 vs.76.1±2.3)和SctO_(2)相对最大降幅(23.0±4.9 vs.14.2±5.0)均显著降低。舒芬太尼组术后一天MoCA评分明显高于芬太尼组。此外,舒芬太尼组POCD的发生率明显低于芬太尼组。结论:舒芬太尼比芬太尼具有更好的镇痛镇静作用,患者恢复更快,POCD发生率更低,可首选用于老年患者接受髋关节置换术。Objective To evaluate the effect of sufentanil on cerebral oxygen saturation(SctO_(2))and postoperative cognitive function in elderly patients undergoing total hip replacement.Methods Patients over the age of 65 who received hip joint replacement surgery were included for the study between September 2016 and August 2019.88 patients were randomly divided into two groups:sufentanil group and fentanyl group.The recovery time of anesthesia,sedation level,changes of SctO_(2) and POCD were recorded.Results The recovery time of anesthesia in sufentanil group was significantly lower than that in fentanyl group,and the VAS scores at 5,10,30 and 60 min after extubation were significantly lower than those in fentanyl group,while the Ramsay scores at 5,10min after extubation were significantly higher than that in fentanyl group.Compared with fentanyl group,the average SctO_(2)(73.9±1.5vs.76.1±2.3) and the relative maximum decrease of SctO_(2)(23.0±4.9vs.14.2±5.0) in sufentanil group were significantly decreased.MoCA score of sufentanil group was significantly higher than that of fentanyl group one day after operation.In addition,the incidence of POCD was significantly lower in the sufentanil group than that of the fentanyl group.Conclusion Compared with fentanyl,sufentanil has better analgesic and sedative effects,faster recovery and lower incidence of POCD,so it can be the first choice for elderly patients undergoing hip replacement.

关 键 词：舒芬太尼 老年 髋关节置换术 脑氧饱和度 术后认知功能 

分 类 号：R614[医药卫生—麻醉学]