右美托咪定对老年骨科手术患者全麻恢复及术后早期认知功能的影响

发布时间：2019-06-06 09:17

【摘要】：目的观察右美托咪定对老年骨科手术患者全麻恢复及术后早期认知功能(POCD)的影响。方法将60例择期行全身麻醉老年骨科手术患者随机分为A、B、C组各20例,入室平卧10 min后,A组持续泵注右美托咪定0.4μg/(kg·h),B组先以右美托咪定0.4μg/kg(15 min)负荷剂量后再持续泵注0.4μg/(kg·h),C组不用右美托咪定。记录各组脑电双频指数(BIS)、全麻恢复指标、不良事件发生情况及心血管活性药物使用情况;术后24、72 h行简易智能量表评分,判断POCD发生情况。结果各组术中BIS、舒芬太尼用量、全麻恢复指标比较,P均0.05。与C组相比,A、B组严重高血压发生率降低,乌拉地尔使用率降低,P均0.05;B组心动过速发生率降低,艾司洛尔使用率降低,P均0.05。与C组比较,A、B组术后24 h的POCD发生率降低(P均0.05)。结论右美托咪定可维持老年患者全麻恢复期血流动力学稳定,且不延长苏醒时间,并可减少POCD发生率。
[Abstract]:Objective to observe the effect of dexmetomide on general anesthesia recovery and early postoperative cognitive function (POCD) in elderly patients undergoing orthopaedic surgery. Methods Sixty elderly patients undergoing general anesthesia undergoing orthopedic surgery were randomly divided into group A (n = 20) and group C (n = 20). After lying flat for 10 min, group A was continuously injected with dexmetomide 0.4 渭 g / (kg 路h),). Group B was loaded with right metomipramine 0.4 渭 g / kg (15 min) before continuous infusion of 0.4 渭 g / (kg 路h), C). The recovery index of (BIS), general anesthesia, the occurrence of adverse events and the use of cardiovascular active drugs in each group were recorded, and the incidence of POCD was judged by simple intelligence scale score at 24 h and 72 h after operation. Results the dosage of BIS, sufentanil and the recovery index of general anesthesia in each group were 0.05% (P < 0.05). Compared with group C, the incidence of severe hypertension and the utilization rate of urapidil in group A and group B were lower than those in group C (P < 0.05). The incidence of tachycardia and esmolol in group B (P < 0.05) were lower than those in group C (P < 0.05). Compared with group C, the incidence of POCD in group B decreased 24 hours after operation. Conclusion dexmetomide can maintain hemodynamic stability during general anesthesia recovery in elderly patients, not prolong recovery time, and reduce the incidence of POCD.
【作者单位】：潍坊市人民医院;
【分类号】：R614

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