艾司氯胺酮联合氟比洛芬酯超前镇痛对老年髋关节置换术患者术后认知功能、疼痛介质和氧化应激的影响  

Effects of Preemptive Analgesia with Esketamine Combined with Flurbiprofen Axetil on Postoperative Cognitive Function,Pain Mediators and Oxidative Stress in Elderly Patients Undergoing Hip Replacement Operation

作　　者：孙新宇 杨帆[2] 孙聪 吴楠[1] 赵丁[3] 仇金鹏[2] SUN Xin-yu;YANG Fan;SUN Cong;WU Nan;ZHAO Ding;QIU Jin-peng(Department of Anesthesiology,The First Hospital of Jilin University,Changchun,Jilin,130021,China;Department of Anesthesiology,Lequn Campus of The First Hospital of Jilin University,Changchun,Jilin,130061,China;Department of Orthopaedics,Lequn Campus of The First Hospital of Jilin University,Changchun,Jilin,130061,China)

机构地区：[1]吉林大学第一医院麻醉科,吉林长春130021 [2]吉林大学第一医院乐群院区麻醉科,吉林长春130061 [3]吉林大学第一医院乐群院区骨科,吉林长春130061

出　　处：《现代生物医学进展》2024年第21期4176-4178,共3页Progress in Modern Biomedicine

基　　金：吉林省科技厅自然科学基金项目(20180101162JC)。

摘　　要：目的:观察老年髋关节置换术(THA)患者经氟比洛芬酯超前镇痛、艾司氯胺酮联合麻醉,患者术后认知功能、疼痛介质和氧化应激的变化情况。方法:采用随机数字表法将162例老年THA患者分为对照组(氟比洛芬酯超前镇痛)和研究组(艾司氯胺酮联合氟比洛芬酯超前镇痛),每组各为81例。比较两组蒙特利尔认知评估量表(MoCA)、疼痛介质[前列腺素E2(PGE2)、P物质(SP)和β-内啡肽(β-EP)]、氧化应激指标[晚期氧化蛋白产物(AOPP)、脂质过氧化物(LPO)、谷胱甘肽过氧化物酶(GSH-Px)]和不良反应。结果:研究组术后3 d、术后7 d MoCA评分高于对照组(P<0.05)。与对照组相比,研究组术后1 d SP、PGE2、LPO、AOPP更低,GSH-Px、β-EP更高(P<0.05)。不良反应发生率对照组为8.64%,研究组为7.41%,比较无差异(P>0.05)。结论:艾司氯胺酮联合氟比洛芬酯超前镇痛用于老年THA患者,可有效控制疼痛介质和氧化应激,减轻术后认知功能障碍,镇静、镇痛作用可靠。Objective:To observe the changes of postoperative cognitive function,pain mediators and oxidative stress in elderly patients undergoing hip arthroplasty(THA)after preemptive analgesia with flurbiprofen axetil and combine anesthesia with esketamine.Methods:162 elderly THA patients were divided into control group(flurbiprofen axetil preemptive analgesia)and study group(esketamine combine with flurbiprofen axetil preemptive analgesia)by random number table method,81 cases in each group.The Montreal cognitive assessment scale(MoCA),pain mediators[prostaglandin E2(PGE2),substance P(SP)andβ-endorphin(β-EP)],oxidative stress indexes[advanced oxidation protein products(AOPP),lipid peroxides(LPO),glutathione peroxidase(GSH-Px)]and adverse reactions were compared in two groups.Results:The MoCA score in study group was higher than that in control group at 3 days and 7 days after operation(P<0.05).Compared with the control group,the study group had lower SP,PGE2,LPO,AOPP,while had higher GSH Px,andβ-EP(P<0.05).The incidence of adverse reactions was 8.64%in the control group and 7.41%in the study group,there was no difference(P>0.05).Conclusion:Preemptive analgesia with esketamine combined with flurbiprofen axetil for elderly THA patients,which can effectively control pain mediators and oxidative stress,reduce postoperative cognitive dysfunction,and have reliable sedative and analgesic effects.

关 键 词：艾司氯胺酮 氟比洛芬酯 超前镇痛 老年 髋关节置换术 认知功能 疼痛介质 氧化应激 

分 类 号：R687[医药卫生—骨科学] R684[医药卫生—外科学]