右美托咪定用于老年患者腰椎术全麻镇痛的疗效及对术后认知功能的影响

发布时间：2018-04-27 01:24

本文选题：右美托咪定 + 腰椎全麻手术　；参考：《中国老年学杂志》2015年15期

【摘要】：目的探讨右美托咪定用于老年患者腰椎术全麻镇痛及术后认知功能的影响。方法选取2012年10月至2014年9月该院收治的81例腰椎间盘突出患者以及45例腰椎骨折患者,均择期进行腰椎全麻手术治疗。将126例患者随机分为右美托咪定0.5μg组(低剂量组)、1.0μg组(高剂量组)以及对照组各42例。麻醉诱导后,低剂量、高剂量组分别按照0.5、1.0μg/kg的剂量持续泵入右美托咪定,对照组给予同等剂量的生理盐水。记录患者术后高血压以及窦性心律过缓的发生情况,以及术中患者的尿量、出血量、镇痛药物的使用剂量以及输液量等指标。采用简易智能量表(MMSE)对手术后的认知功能进行评定。结果低剂量、高剂量组患者芬太尼、瑞芬太尼、丙泊酚的使用剂量均明显低于对照组;且高剂量组患者的镇痛药物的使用剂量亦显著低于低剂量组;低、高剂量组患者高血压以及窦性心律过缓的发生率均明显高于对照组;低剂量、对照组认知功能障碍的发生率均显著高于高剂量组(P0.05)。结论右美托咪定应用于老年患者腰椎术全麻镇痛时,在降低围术期镇静药物以及阿片类药物的给药剂量、改善术后认知功能方面具有明显的优势。
[Abstract]:Objective to investigate the effect of dexmetomidine on general anesthesia analgesia and postoperative cognitive function in elderly patients. Methods from October 2012 to September 2014, 81 patients with lumbar disc herniation and 45 patients with lumbar vertebrae fracture were treated with lumbar general anesthesia. 126 patients were randomly divided into dexmetomidine 0.5 渭 g group (low dose group 1.0 渭 g group) and control group (42 cases). After anesthesia induction, the low-dose and high-dose groups were continuously pumped into dexmetomidine at the dose of 0.5 渭 g/kg, while the control group was given the same dose of normal saline. The incidence of postoperative hypertension and sinus arrhythmia, urine volume, blood loss, dosage of analgesic drugs and infusion volume were recorded. The cognitive function after operation was evaluated by MMSE. Results the dosage of fentanyl, remifentanil and propofol in low dose group was significantly lower than that in control group, and the dosage of analgesic drug in high dose group was significantly lower than that in low dose group. The incidence of hypertension and sinus bradycardia in the high dose group was significantly higher than that in the control group, and the incidence of cognitive dysfunction in the low dose group was significantly higher than that in the high dose group (P 0.05). Conclusion dexmetomidine has obvious advantages in reducing the dosage of sedatives and opiates and improving postoperative cognitive function in elderly patients with lumbar spine general anesthesia analgesia.
【作者单位】：胜利油田中心医院麻醉科;
【分类号】：R614

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