摘要
目的探讨右美托咪定复合硬膜外麻醉对老年疝气手术患者应激反应指标、呼吸循环指标及认知功能的影响。方法选择2018年3月至2019年3月我院收治的130例老年疝气手术患者为研究对象,根据麻醉方式不同将其分为对照组和观察组,各65例。对照组接受常规硬膜外麻醉,观察组在对照组基础上给予右美托咪定复合硬膜外麻醉。比较两组的应激反应指标、呼吸循环指标、认知功能和术后恢复情况。结果T_(0)时,两组的NE和Cor水平比较,差异无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时,两组的NE和Cor水平均高于T_(0)时,差异具有统计学意义(P<0.05);T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时,观察组的NE、Cor水平均低于对照组,差异具有统计学意义(P<0.05)。T_(0)时,两组的SpO_(2)、RR比较,差异无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时,观察组的SpO_(2)、RR与T_(0)时比较,差异无统计学意义(P>0.05),但对照组显著低于T_(0)时(P<0.05);T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时,观察组的SpO_(2)、RR均高于对照组,差异具有统计学意义(P<0.05)。术前,两组的MMSE、MoCA评分比较,差异无统计学意义(P>0.05);术后7 d,两组的MMSE、MoCA评分均低于术前,差异具有统计学意义(P<0.05);术后7 d,观察组的MMSE、MoCA评分高于对照组,差异具有统计学意义(P<0.05)。两组的苏醒时间、拔管时间及离开恢复室时间比较,差异无统计学意义(P>0.05);观察组的镇静-躁动评分、FSS评分低于对照组,QoR-40评分高于对照组,差异具有统计学意义(P<0.05)。结论右美托咪定复合硬膜外麻醉应用于老年疝气手术患者中,可有效缓解应激反应,且对呼吸循环及认知功能无明显影响,还能改善术后恢复效果,值得推广。
Objective To investigate the effects of dexmedetomidine combined with epidural anesthesia on stress response indexes,respiratory and circulatory indexes and cognitive function in elderly patients undergoing hernia surgery.Methods A total of 130 elderly patients undergoing hernia surgery treated in our hospital from March 2018 to March 2019 were selected as the research objects.According to different anesthesia methods,the patients were divided into control group and observation group,with 65 cases in each group.The control group received routine epidural anesthesia,and the observation group was given dexmedetomidine combined epidural anesthesia on the basis of the control group.The stress response indexes,respiratory and circulatory indexes,cognitive function and postoperative recovery were compared between the two groups.Results At T_(0),there were no significant differences in the levels of NE and Cor between the two groups(P>0.05);at T_(1),T_(2),T_(3),T_(4) and T_(5),the levels of NE and Cor in the two groups were higher than those at T_(0),and the differences were statistically significant(P<0.05);at T_(1),T_(2),T_(3),T_(4) and T_(5),the levels of NE and Cor in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At T_(0),there were no significant differences in SpO_(2) and RR between the two groups(P>0.05);at T_(1),T_(2),T_(3),T_(4) and T_(5),there were no significant differences in SpO_(2) and RR compared with those at T_(0) in the observation group(P>0.05),but those were significantly lower than at T_(0) in the control group(P<0.05);at T_(1),T_(2),T_(3),T_(4) and T_(5),SpO_(2) and RR in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Before operation,there were no significant differences in MMSE and MoCA scores between the two groups(P>0.05);7 d after operation,the MMSE and MoCA scores of the two groups were lower than those before operation,and the differences were statistically significant(P<0.05);7 d after operation,the MMSE and MoCA scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in recovery time,extubation time and leaving recovery room time between the two groups(P>0.05);the sedation agitation score and FSS score of the observation group were lower than those of the control group,and the QoR-40 score was higher than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Dexmedetomidine combined with epidural anesthesia in elderly patients undergoing hernia surgery can effectively alleviate the stress response,have no significant effect on respiratory circulation and cognitive function,and improve the postoperative recovery effect,which is worthy of popularization.
作者
王晓
WANG Xiao(the Hospital of Chengcheng County,Weinan 715299,China)
出处
《临床医学研究与实践》
2022年第9期101-104,共4页
Clinical Research and Practice
关键词
右美托咪定
硬膜外麻醉
老年疝气手术
应激反应
认知功能
呼吸循环
dexmedetomidine
epidural anesthesia
elderly hernia surgery
stress response
cognitive function
respiratory and circulation
