| 贾梦.右美托咪定对老年股骨颈骨折患者全麻术后镇痛及认知功能的影响[J].浙江中西医结合杂志,2021,31(8): |
| 右美托咪定对老年股骨颈骨折患者全麻术后镇痛及认知功能的影响 |
| Effect of general anesthesia assisted with dexmedetomidine on analgesia and postoperative cognitive function in elderly patients with femoral neck fracture |
| 投稿时间：2021-02-27 修订日期：2021-05-26 |
| DOI： |
| 中文关键词: 股骨颈骨折 右美托咪定 全身麻醉 术后镇痛 认知功能 |
| 英文关键词:Femoral neck fracture Dexmedetomidine General anesthesia Analgesic effect Cognitive function |
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| 中文摘要: |
| 目的： 探讨右美托咪定对老年股骨颈骨折患者全麻术后镇痛及认知功能的影响。方法 ：选择92例老年股骨颈骨折患者并随机分为两组,观察组全身麻醉前联合应用右美托咪定,对照组患者不予应用,比较两组患者不同时间点包括麻醉诱导前(T0)、气管插管完成时(T1)以及手术开始后1h(T2)、手术结束时(T3)、拔管时(T4)时平均动脉压(MAP)和心率(HR)情况；比较两组手术后疼痛及认知功能情况。结果： 在T1、T4时点,MAP、HR在两组患者均明显高于T0,但是观察组明显低于对照组,差异均有统计学意义(P＜0.05)；观察组在麻醉清醒后2h、4h、6h及8h时的视觉模拟评分法(VAS)评分均明显低于对照组,差异均有统计学意义(P＜0.05)；术后1d,两组患者MMSE评分与术前比较均降低明显,但是观察组高于对照组,差异均有统计学意义(P＜0.05)；术后7d,MMSE评分在观察组患者恢复到术前水平(P＞0.05),但是在对照组患者仍低于术前(P＜0.05)。结论 老年股骨颈骨折患者全身麻醉应用右美托咪定有利于维持血流动力学稳定性,且能够减轻术后疼痛程度,改善术后认知功能。 |
| 英文摘要: |
| Objective To investigate the effect of general anesthesia assisted with dexmedetomidine on analgesia and postoperative cognitive function in elderly patients with femoral neck fracture. Methods 92 cases of elderly patients with femoral neck fracture were selected and randomly divided into two groups. The observation group was given dexmedetomidine before general anesthesia, while the control group was not given dexmedetomidine. The MAP and HR at different time points of the two groups were compared, including before anesthesia induction (T0), the completion of endotracheal intubation (T1), 1 hour after operation (T2), the end of operation (T3), extubation (T4) The pain after anesthesia and the cognitive function of the two groups were compared. Results At T1, T4, MAP, HR in both groups were significantly higher than T0, but the observation group was significantly lower than the control group (P < 0.05); the VAS scores of the observation group at 2 h, 4 h, 6 h and 8 h after anesthesia were significantly lower than the control group (P < 0.05); the MMSE scores of the two groups were significantly lower than before operation on the 1d after operation, But the observation group was higher than the control group, the differences were significant (P < 0.05); 7 d after operation, MMSE score in the observation group recovered to the preoperative level (P > 0.05), but in the control group was still lower than before operation (P < 0.05). Conclusion The application of dexmedetomidine assisted by general anesthesia in elderly patients with femoral neck fracture is conducive to maintaining hemodynamic stability, reducing postoperative pain and improving postoperative cognitive function. |
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