持续泵注小剂量右美托咪定联合舒芬太尼对老年关节镜手术患者镇痛、炎症反应及认知功能的影响  

Effects of Continuous Pumping of Low Dose Dexmedetomidine Combined with Sufentanil on Analgesia,Inflammation and Cognitive Function in El⁃derly Patients Undergoing Arthroscopic Surgery

作　　者：陈有明 袁桂英 朱俊勇 CHEN Youming;YUAN Guiying;ZHU Junyong(Department of Anesthesiology,People's Hospital of Suxitong Science and Technology Industrial Park,Nantong 226311,Jiangsu,China;Department of Anesthesiology,The Sixth People's Hospital of Nantong,Nantong 226001,Ji‐angsu,China)

机构地区：[1]苏锡通科技产业园区人民医院麻醉科,江苏南通226311 [2]南通市第六人民医院麻醉科,江苏南通226001

出　　处：《系统医学》2024年第24期78-81,共4页Systems Medicine

摘　　要：目的 研究持续泵注小剂量右美托咪定联合舒芬太尼对老年关节镜手术患者镇痛、炎症反应及认知功能的影响。方法 非随机选取2022年1月—2023年12月苏锡通科技产业园区人民医院接受关节镜手术治疗的108例老年患者为研究对象,根据不同镇痛方式将其分为联合组与参照组,各54例。关节镜手术结束前10 min,给予参照组舒芬太尼注射液持续泵注,联合组在此基础上联合小剂量0.06μg/(kg·h)右美托咪定持续泵注。观察两组术后各时间点的视觉模拟评分法(Visual Analog Score,VAS)评分,对比术前、术后24 h的炎症反应指标[白细胞介素8(interleukin8, IL-8)、白细胞介素6(interleukin 6, IL-6)、肿瘤坏死因子α(tumor necrosis factor-α, TNF-α)],并比较其术前及术后24、48 h的蒙特利尔认知评估量表(Montreal Cognitive Assessment, MoCA)、简易精神状态检查(Mini-Mental State Examination, MMSE)评分。结果 术后3、6、8、12 h的VAS评分对比,联合组较参照组低,差异有统计学意义(P均<0.05)。术后24 h,联合组IL-6、TNF-α、IL-8表达水平为(27.23±5.75)pg/mL、(6.76±1.71)μg/L、(210.43±21.36)pg/mL,均低于参照组的(32.68±6.19)pg/mL、(8.41±1.83)μg/L、(231.38±24.49)pg/mL,差异有统计学意义(t=4.740、4.841、4.737,P均<0.05)。术后24、48 h,联合组MMSE、MoCA评分高于参照组,差异有统计学意义(P均<0.05)。结论 持续泵注小剂量右美托咪定联合舒芬太尼能帮助老年关节镜手术患者进行有效镇痛,并减轻炎症反应,对其术后认知功能、精神状态的早期恢复有积极意义。Objective The effects of continuous low-dose dexmedetomidine combined with sufentanil infusion on anal‐gesia,inflammation,and cognitive function in elderly patients undergoing arthroscopic surgery were investigated.Methods A total of 108 elderly patients who underwent arthroscopic surgery in People's Hospital of Suxidong Science and Technology Industrial Park from January 2022 to December 2023 were non-randomly selected as the research ob‐jects.According to different analgesic methods,they were divided into the combined group and the reference group,with 54 cases in each group.Ten minutes before the end of arthroscopic surgery,the control group was given continu‐ous pump injection of sufentanil injection,and the combined group was given a small dose of 0.06μg/(kg·h)dexme‐detomidine continuous pump injection on this basis.The Visual Analog Score(VAS)score of the two groups at each time point after operation was observed.The inflammatory response indexes[interleukin8(IL-8),interleukin6(IL-6),tumor necrosis factor-α(TNF-α)]before and 24 hours after operation were compared.The Montreal Cognitive Assess‐ment(MoCA)and Mini-Mental State Examination(MMSE)scores were compared before operation and 24 h and 48 h after operation.Results The VAS scores at 3,6,8 and 12 hours after operation in the combined group were lower than those in the control group,and the differences were statistically significant(all P<0.05).At 24 h after operation,the ex‐pression levels of IL-6,TNF-α,IL-8 in the combined group were(27.23±5.75)pg/mL,(6.76±1.71)μg/L,(210.43±21.36)pg/mL,compared with the control group[(32.68±6.19)pg/mL,(8.41±1.83)μg/L,(231.38±24.49)pg/mL],the differences were statistically significant(t=4.740,4.841,4.737,all P<0.05).At 24 h and 48 h after operation,the MMSE and MoCA scores of the combined group were higher than those of the reference group,and the differences were statistically significant(all P<0.05).Conclusion Continuous infusion of small doses of dexmedetomidine com‐bined with sufentanil can

关 键 词：舒芬太尼 关节镜手术 镇痛 炎症反应 右美托咪定 

分 类 号：R614[医药卫生—麻醉学]