右美托咪定联合利多卡因静脉应用对胸腔镜手术患者术后镇痛和认知功能的影响  

Effects of intravenous dexmedetomidine combined with lidocaine on postoperative analgesia and cognitive function in patients undergoing thoracoscopic surgery

作　　者：李培志 曲俊星 陈胜阳[3] 孙志恒 LI Peizhi;QU Junxing;CHEN Shengyang;SUN Zhiheng(Department of Anesthesiology,The First People's Hospital of Xinxiang,Xinxiang 453000,China;Zhongyuan Institute of Health Research,Xinxiang Medical College,Xinxiang 453000,China;Department of Anesthesiology,The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;College of Life Sciences,Henan Normal University,Xinxiang 453000,China)

机构地区：[1]新乡市第一人民医院麻醉科,新乡453000 [2]新乡医学院健康中原研究院,新乡453000 [3]新乡医学院第一附属医院麻醉科,新乡453000 [4]河南师范大学生命科学学院,新乡453000

出　　处：《济宁医学院学报》2024年第4期311-314,共4页Journal of Jining Medical University

基　　金：新乡医学院科研启动基金(505501)。

摘　　要：目的探究胸腔镜手术患者术中静脉应用右美托咪定联合利多卡因对术后镇痛和认知功能障碍的影响。方法选取新乡市第一人民医院2021年7月-2023年7月需要胸腔镜手术的患者180例,按照数字表法随机将其分成3组,A组:右美托咪定组(n=60);B组:利多卡因组(n=60);C组:右美托咪定联合利多卡因(n=60),分别比较3组术后6、12、24、48h时视觉模拟评分(VAS)、简易精神状态检查量表(MMSE)评分。结果C组较A组、B组T1、T2、T3、T4时VAS评分更低,且A组较B组各阶段评分更低(P<0.05);C组较A组、B组T2、T3、T4时术后TNF-α、IL-6水平更低(P<0.05),且A组较B组术后TNF-α、IL-6水平更低(P<0.05);C组较A组、B组术后6、12、24、48h认知功能评分更高(P<0.05),但A组、B组无明显差异(P>0.05);上述结果均表明不同组别、不同时间点之间VAS、MMSE对比均存在显著差异。结论胸腔镜手术患者术中静脉应用右美托咪定联合利多卡因,不仅能够减轻患者术后疼痛感,而且能较快恢复认知功能。Objective To explore the effects of intravenous injection of dexmedetomidine combined with lidocaine on postoperative analgesia and cognitive dysfunction in patients undergoing thoracoscopic surgery.Methods A total of 180 patients requiring thoracoscopic surgery in Xinxiang First People's hospital from July 2021 to July 2023 were randomly divided into three groups according to the numerical table method.Group A:dexmedetomidine group(n=60);Group B:lidocaine group(n=60);Group C:dexmedetomidine combined with lidocaine(n=60),visual analogue score(VAS),simple mental state Examination Scale(MMSE)were compared at 6h,12h,24h and 48h,respectively.Results The VAS scores at T1,T2,T3 and T4 in group C were lower than those in groups A and B,and the scores in group A were lower than those in group B(P<0.05).The levels of postoperative inflammatory factors at T2,T3 and T4 in group C were lower than those in groups A and B(P<0.05),and the levels of postoperative inflammatory factors in group A were lower than those in group B(P<0.05).The cognitive function scores of group C were higher than those of group A and group B at 6h,12h,24h and 48h after operation(P<0.05),but there was no significant difference between group A and group B(P>0.05).The above results all indicate that there are significant differences in VAS,MMSE between different groups and different time points.Conclusion Intravenous injection of dexmedetomidine combined with lidocaine in patients undergoing thoracoscopic surgery can not only reduce postoperative pain.

关 键 词：右美托咪定 利多卡因 胸腔镜手术 镇痛效果 认知功能 

分 类 号：R614[医药卫生—麻醉学]