右美托咪定对七氟烷麻醉后髋关节置换术后患者认知功能的影响  

Effects of Dexmedetomidine on Cognitive Function in Patients after Hip Arthroplasty under Sevoflurane Anesthesia

作　　者：李娟[1] 杨宇[1] 孙宝侠 谢明锐 LI Juan;YANG Yu;SUN Baoxia;XIE Mingrui(Department of Anesthesiology,Mianyang Central Hospital,Mianyang,Sichuan Province,621000 China)

机构地区：[1]绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《世界复合医学》2022年第11期173-176,共4页World Journal of Complex Medicine

基　　金：绵阳市中心医院科研课题基金项目(2020YJ10)。

摘　　要：目的观察右美托咪定对七氟烷麻醉后髋关节置换术后患者认知功能的影响。方法选取2019年1月—2020年12月在绵阳市中心医院行髋关节置换术的患者138例作为研究对象,随机分为观察组与对照组,其中观察组70例应用右美托咪定对七氟烷麻醉后认知功能障碍预防,对照组68例应用等量生理盐水。比较两组患者麻醉前和术后第1、3、7天的认知功能情况;记录两组患者麻醉后恶心呕吐、心率异常等不良反应发生率;对比麻醉前、麻醉后15 min、麻醉后30 min、麻醉后1 h时患者生命体征变化及术后6、12、24、48 h VAS评分。结果术后第1、3、7天,观察组MMSE评分分别为(22.45±3.98)分,(24.04±2.74)分,(26.65±2.13)分,高于对照组的(20.24±2.78)分,(21.87±3.86)分,(23.09±1.97)分,差异有统计学意义(t=3.771、3.817、10.185,P<0.05);两组术后6、12、24、48 hVAS评分经评测呈降低趋势,且观察组较对照组更低,差异有统计学意义(P<0.05);两组患者麻醉前、麻醉后15 min、麻醉后30 min及麻醉后1 h的MAP比较,差异无统计学意义(P>0.05);两组恶心呕吐、心率异常、呼吸抑制不良反应发生率对比(7.14%vs 4.41%),差异无统计学意义(χ^(2)=0.103,P>0.05)。结论右美托咪定对七氟烷麻醉后髋关节置换术患者,能维持血流动力学稳定,减轻患者术后疼痛,降低认知功能障碍的发生率,对后期恢复具有积极意义。Objective To observe the effect of dexmedetomidine on the cognitive function of patients after hip arthroplasty after sevoflurane anesthesia.Methods 138 patients who underwent hip arthroplasty in Mianyang Central Hospital from January 2019 to December 2020 were selected as the study subjects and randomly divided into the observation group and the control group.Among them,70 cases in the observation group applied dexmedetomidine for the prevention of cognitive dysfunction after sevoflurane anesthesia,and 68 cases in the control group applied equal amount of saline.The cognitive functions of the patients in the two groups were compared before anesthesia and in the 1 d,3 d and 7 d after surgery.The rates of adverse reactions such as post-anesthesia nausea and vomiting and abnormal heart rate were recorded in the two groups.The changes in vital signs at the pre-anesthesia time point,15 min after anerthesia,30 min after anerthesia,and 1 h after anesthesia and the VAS scores at 6 h,12 h,24 h,and 48 h after surgery were compared.Results On the 1st,3rd and 7th day after operation,the MMSE evaluation scores of the observation group were(22.45±3.98)points,(24.04±2.74)points,(26.65±2.13)points,higher than the(20.24±2.78)points,(21.87±3.86)points,(23.09±1.97)points in the control group,the difference was statistically significant(t=3.771,3.817,10.185,P<0.05).The VAS scores of 6 h,12 h,24 h and 48 h VAS of the two groups showed a decreasing trend,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in MAP between the two groups before anesthesia,15 min after anesthesia,30 min after anesthesia and 1 h after anesthesia(P>0.05).Compared the incidence of nausea and vomiting,abnormal heart rate,respiratory depression adverse reactions between the two groups(7.14%vs 4.41%),the difference was not statistically significant(χ^(2)=0.471,P>0.05).Conclusion Dexmedetomidine can maintain hemodynamic stability,reduce postopera

关 键 词：右美托咪定 七氟烷 髋关节置换术 认知功能 

分 类 号：R614[医药卫生—麻醉学]