依托咪酯靶控输注复合帕瑞昔布钠超前镇痛麻醉对膝关节置换术后患者氧化应激及认知功能的影响  

Effect of Target-Controlled Infusion of Etomidate Combined with Parecoxib Sodium for Preemptive Analgesia on Oxidative Stress and Cognitive Function After Knee Arthroplasty

作　　者：黄珍[1] 王勇[1] 黎浪 李宇峰 HUANG Zhen;WANG Yong;LI Lang;LI Yufeng(The Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha,Hunan,China 410005;Hunan Rehabilitation Hospital,Changsha,Hunan,China 410007)

机构地区：[1]湖南中医药大学第二附属医院,湖南长沙410005 [2]湖南省康复医院,湖南长沙410007

出　　处：《中国药业》2025年第9期85-89,共5页China Pharmaceuticals

基　　金：湖南省卫生健康委员会科研立项课题[20201290]。

摘　　要：目的探讨依托咪酯靶控输注复合帕瑞昔布钠超前镇痛麻醉对膝关节置换术后患者氧化应激及认知功能的影响。方法选取湖南中医药大学第二附属医院2021年3月至2023年3月收治的行膝关节置换术的患者93例,按随机数字表法分为对照组(45例)和研究组(48例)。两组患者均予帕瑞昔布钠超前镇痛,研究组患者加用依托咪酯靶控输注。结果与术前比较,两组患者术后12,24,48 h的视觉模拟评分法(VAS)、简易智力状态检查量表(MMSE)评分均显著降低(P<0.05),膝关节功能评分法(HSS)评分均显著升高(P<0.05),且研究组均显著优于对照组(P<0.05);两组患者术后1,2 h的心率、平均动脉压均显著升高(P<0.05),但研究组均显著低于对照组(P<0.05);两组患者术后12,24,48 h的白细胞介素6、C反应蛋白、肿瘤坏死因子-α、去甲肾上腺素、皮质醇水平均显著升高(P<0.05),但研究组均显著低于对照组(P<0.05)。研究组和对照组患者的不良反应发生率相当(14.58%比13.33%,P>0.05)。结论依托咪酯靶控输注复合帕瑞昔布钠超前镇痛麻醉对膝关节置换术患者血流动力学、应激反应、炎性因子水平的影响较小,且患者术后疼痛程度较轻,认知功能和膝关节功能均提高,麻醉效果理想。Objective To investigate the effect of target-controlled infusion of etomidate combined with parecoxib sodium for preemptive analgesia on oxidative stress and cognitive function after knee arthroplasty.Methods A total of 93 patients who underwent knee arthroplasty in the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine from March 2021 to March 2023 were selected and randomly divided into the control group(45 cases)and the study group(48 cases)by the random number table method.The patients in the two groups received preemptive analgesia with parecoxib sodium,on this basis,the patients in the study group received target-controlled infusion of etomidate.Results Compared with those before surgery,the Visual Analog Scale(VAS)scores and Mini-Mental State Examination(MMSE)scores at 12,24,and 48 h after surgery in the two groups significantly decreased(P<0.05),while the knee joint function score(HSS)scores at 12,24,and 48 h after surgery significantly increased(P<0.05),and those in the study group were significantly better than those in the control group(P<0.05);the heart rate and mean arterial pressure in the two groups at 1 and 2 h after surgery significantly increased(P<0.05),but those in the study group were significantly lower than those in the control group(P<0.05);the levels of interleukin-6,C-reactive protein,tumor necrosis factor-α,norepinephrine,and cortisol at 12,24,and 48 h after surgery in the two groups significantly increased(P<0.05),but those in the study group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions was comparable between the study group and the control group(14.58%vs.13.33%,P>0.05).Conclusion Target-controlled infusion of etomidate combined with parecoxib sodium for preemptive analgesia has little effect on hemodynamics,stress response,and inflammatory factor levels in patients undergoing knee arthroplasty,which can reduce the postoperative pain degree,improve cognitive function and knee joint function,and has ide

关 键 词：膝关节置换术 依托咪酯靶控输注 帕瑞昔布钠超前镇痛 氧化应激 认知功能 

分 类 号：R969.4[医药卫生—药理学] R971.2[医药卫生—药学]