盐酸纳布啡联合咪达唑仑对老年腰椎体成型术患者镇痛效果、术后寒战及认知功能障碍的临床观察  

Clinical effects of nalbuphine hydrochloride combined with midazolam on analgesic effect,postoperative chills and cognitive dysfunction in elderly patients undergoing lumbar vertebroplasty

作　　者：杨静蕊[1] 董玥颖 才素分[1] YANG Jing-rui;DONG Yue-ying;CAI Su-fen(Department of Anesthesiology,Tangshan Second Hospital,Tangshan 063015,Hebei,China)

机构地区：[1]唐山市第二医院麻醉科,河北唐山063015

出　　处：《川北医学院学报》2021年第11期1493-1495,1500,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨盐酸纳布啡联合咪达唑仑对老年腰椎体成型术患者镇痛效果、术后寒战及认知功能障碍(POCD)的影响。方法:选取86例老年腰椎体成型术患者为研究对象,按麻醉方案不同分为观察组和对照组,每组各43例。对照组患者予以舒芬太尼联合咪达唑仑麻醉;观察组患者予以盐酸纳布啡联合咪达唑仑麻醉。比较两组患者镇痛效果[视觉模拟评分(VAS评分)]、术后寒战发生情况、认知功能[简易精神状态检查量表评分(MMSE评分)及POCD发生率]和不良反应发生率。结果:术后1、6、12、24 h,观察组患者VAS评分均低于对照组(P<0.05)。观察组患者术后寒战发生率低于对照组的(P<0.05)。术后24、48 h,观察组患者MMSE评分均高于对照组(P<0.05);POCD发生率低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:盐酸纳布啡联合咪达唑仑能提高老年腰椎体成型术患者的镇痛效果,减少术后寒战,改善认知功能,降低POCD发生率,且不会增加不良反应,具有较高的安全性。Objective:To explore the effects of nalbuphine hydrochloride combined with midazolam on analgesic effect,postoperative chills and postoperative cognitive dysfunction(POCD)in elderly patients undergoing lumbar vertebroplasty.Methods:A total of 86 elderly patients undergoing lumbar vertebroplasty were enrolled as the research objects.They were divided into observation group(n=43)and control group(n=43)by different anesthesia methods.The control group was given sufentanil and midazolam,while observation group was given nalbuphine hydrochloride and midazolam.The analgesic effect[visual analogue scale(VAS)],postoperative chills,cognitive function[score of mini-mental state examination(MMSE),incidence of POCD]and adverse reactions were compared between the two groups.Results:At 1 h,6 h,12 h and 24 h after surgery,VAS score in observation group was lower than that in control group(P<0.05).The incidence of postoperative chills in observation group was lower than that in control group(P<0.05).At 24 h and 48 h after surgery,MMSE score in observation group was higher than that in control group(P<0.05).The incidence of POCD in observation group was lower than that in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Nalbuphine hydrochloride combined with midazolam can improve analgesic effect in elderly patients undergoing lumbar vertebroplasty,reduce postoperative chills,improve cognitive function,reduce the incidence of POCD and will not increase adverse reactions,with high safety.

关 键 词：腰椎体成型术 盐酸纳布啡 咪达唑仑 镇痛效果 寒战 认知功能障碍 老年 

分 类 号：R595.6[医药卫生—内科学]