七氟烷复合右美托咪定对老年开胸患者术后早期认知功能的影响

发布时间：2018-05-04 05:52

本文选题：七氟烷 + 右美托咪定　；参考：《中国老年学杂志》2015年08期

【摘要】：目的探讨七氟烷复合右美托咪定对老年开胸患者术后早期认知功能的影响。方法选取该院2012年3月至2014年4月收治的择期行肺叶切除术的老年患者54例,随机分为实验组和对照组27例。两组采取相同的诱导方法,实验组于麻醉诱导前给予0.5μg/kg右美托咪定泵注15 min,麻醉诱导后继续泵注右美托咪定0.5μg·kg-1·h-1,同时持续吸入1.0%~3.0%七氟烷维持麻醉直至手术结束前约30 min;而对照组采取TCI泵入丙泊酚0.1 mg·kg-1·h-1。观察两组术中、术后的生命体征指标、术中麻醉剂量、术后苏醒指标、术后不良反应发生情况,并对术后认知功能及与认知功能相关的血清标志物的浓度进行测定。结果实验组术中麻醉剂用量明显低于对照组(P0.05);与对照组相比实验组与老年开胸患者术后早期认知功能障碍(POCD)的发生率明显降低(P0.05);实验组术后12 h血清S-100β蛋白、白介素(IL)-6及肿瘤坏死因子(TNF)-α水平对照组比较差异显著(P0.05);实验组术中及恢复期低血压和心动过缓发生率明显高于对照组(P0.05)。结论七氟烷复合右美托咪定能够显著降低老年开胸患者术后POCD的发生,但可能有降低血压及致心动过缓的副作用,使用时需谨慎。
[Abstract]:Objective to investigate the effect of sevoflurane combined with dexmetomidine on early cognitive function after thoracotomy in elderly patients. Methods from March 2012 to April 2014, 54 elderly patients undergoing lobectomy were randomly divided into two groups: experimental group (n = 27) and control group (n = 27). The two groups used the same induction method, The experimental group was injected with 0.5 渭 g/kg dexmetidine for 15 minutes before anesthesia induction, and continued to inject dexmetomidine 0.5 渭 g kg-1 h-1 after anesthesia induction, and maintained anesthesia with 1.0% sevoflurane for 30 minutes before the end of operation, while the control group was injected with propofol 0.1 mg kg-1 h-1 by TCI. The indexes of vital signs, the quantity of anesthetic during operation, the index of recovery after operation, the occurrence of adverse reaction after operation, and the concentration of postoperative cognitive function and serum markers related to cognitive function were measured in the two groups. Results the dosage of anesthetic in the experimental group was significantly lower than that in the control group (P 0.05), the incidence of early cognitive dysfunction (POCD) in the experimental group and the elderly patients with thoracotomy was significantly lower than that in the control group, and the serum S-100 尾 protein was significantly decreased in the experimental group at 12 hours after operation. The levels of IL-6 and TNF- 伪 in the control group were significantly higher than those in the control group (P 0.05), and the incidence of hypotension and bradycardia in the experimental group was significantly higher than that in the control group. Conclusion sevoflurane combined with dexmetidine can significantly reduce the incidence of POCD after thoracotomy in elderly patients, but it may have the side effects of lowering blood pressure and bradycardia.
【作者单位】：武汉市普爱医院麻醉科;
【分类号】：R614

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