摘要
目的探讨右美托咪定+瑞芬太尼+七氟醚麻醉药物配伍及咪唑安定+芬太尼+异氟醚麻醉药物配伍对老年腹腔镜患者术后认知功能的影响。方法将接受全身麻醉下腹腔镜胆囊切除手术的48老年患者按照随机数表法平均分为A组及B组。A组接受右美托咪定+瑞芬太尼+七氟醚药物配伍麻醉,B组则接受咪唑安定+芬太尼+异氟醚药物配伍麻醉。观察并比较2组患者麻醉后不同时刻平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS);观察并比较2组患者自主呼吸恢复时间、定向力恢复时间、呼之睁眼时间以及拔管时间等麻醉恢复情况;观察并比较2组患者术后不同时间简易精神量表(MMSE)评分情况。结果 A组及B组患者在接受麻醉后不同时刻的平均动脉压、心率以及脑电双频指数等指标差异无统计学意义(P均>0.05);与B组患者相比,A组患者术后定向力恢复时间由(23.07±3.31)min显著缩短至(17.65±5.14)min,差异具有统计学意义(P<0.05);除此之外,A组患者术后2及12 h MMSE评分分别为24.01±1.69及26.39±2.05,较B组的20.83±1.62及22.41±1.94均有显著改善,且均具有统计学意义(P均<0.05)。结论在接受腹腔镜手术治疗的老年患者中,右美托咪定+瑞芬太尼+七氟醚麻醉药物配伍在术后认知功能恢复方面优于咪唑安定+芬太尼+异氟醚麻醉药物配伍。
Objective To compare two different anesthetic drug combinations（ dexmedetomidine ＋ remifentanil ＋ sevoflu- rane vs. midazolam ＋ fentanyl ＋ isoflurane） in anesthesia of elderly patients received laparoscopic surgeries. Methods 48 elderly patients received laparoscopic surgeries under general anesthesia were selected and divided into group A and group B randomly and evenly. Anesthetic combinations of dexmedetomidine ＋ remifentanil ＋ sevoflurane were applied in group A,while combinations of midazolam ＋ fentanyl ＋ isoflurane were used in group B. MAP, HR and BIS were compared at different time point after induction of anesthesia ;independent respiratory recovery time, orientation recovery time, eye- o- pening time and extubation time were compared between two groups;MMES score were compared at different time point after surgeries. Results There were no significant differences of MAP, HR and BIS in group A and group B. Compared with group B, orientation recovery time decreased significantly in group A, which was decreased from （23.07 ± 3.31 ） min to （17.65 ±5.14） min（ P 〈 0.05 ） ;furthermore ,MMSE at 2 and 12 hours after surgeries improved significantly in group A than in group B （ All P 〈 0. 05 ）, （24.01 ± 1.69） vs. （20.83 ± 1.62） for 2 h and （26.39 ± 2.05 ） vs. （22.41 ± 1.94） for 12 h. Conclusion The anesthetic drug combinations of dexmedetomidine ＋ remifentanil ＋ sevoflurane showed better effects in POCD recovery than that of midazolam ＋ fentanyl ＋ isoflurane in elderly patients received laparoscopic surgeries.
出处
《中华全科医学》
2014年第6期899-901,共3页
Chinese Journal of General Practice
关键词
老年
麻醉
术后认知障碍
Older age
Anesthesia
Postoperative cognitive dysfunction
