右美托咪定对髋关节术后患者认知功能、血液动力学影响及临床疗效

目的:探讨右美托咪定对髋关节术后患者认知功能、血液动力学及镇痛效果。方法:选取我院近3年所收治的80例髋关节手术患者,按照不同麻醉方式,将其随机分为研究组和对照组,每组患者40例,研究组患者微量泵注右美托咪定,对照组患者泵注生理盐水,对比不同麻醉方式对患者术后认知功能、血液动力学及镇痛效果。结果:在麻醉诱导前及手术后3 d,两组患者简短精神状态量表(Mini-mental State Examination, MMSE)评分对比无统计学差异(P0.05),在手术后1 d、2 d,研究组患者MMSE评分明显高于对照组(P0.05),研究组患者术后认知障碍(Post operative cognitive dysfunction,POCD)发生率明显低于对照组(P0.05);两组患者麻醉诱导前各血流动力学指标舒张压(Diastolic blood pressure,DBP)、心率(Heart rate,HR)、收缩压(Systolic blood pressure,SBP)对比无显著性差异(P0.05),在气管插管时、拔管时、拔管后15 min,研究组患者HR、SBP、DBP均明显低于对照组(P0.05);研究组患者手术后1 h、2 h、6 h、12 h、24 h运动状态及静息状态视觉模拟评分法(Visual analog scales,VAS)疼痛评分明显低于对照组(P0.05)。结论:对髋关节置换术患者行右美托咪定,降低患者术后认知功能障碍发生率,维持患者血流动力学稳定性,镇痛效果良好,值得临床上广泛应用。

Effect of Dexmedetomidine on Cognitive Function, Hemodynamics and Clinical Effect in Patients after Hip Joint Operation

ABSTRACT Objective: To investigate the effect of dexmedetomidine on cognitive function, hemodynamics and analgesia in patients after hip joint operation. Methods: 80 patients with hip joint operation in our hospital in recent 3 years were randomly divided into study group and control group according to different anesthesia methods, 40 patients in each group. Patients in the study group were microinjected with dexmedetomidine, while patients in the control group were injected with normal saline. The cognitive function, hemodynamics and analgesic effect of different anesthesia methods were compared. Results: Before anesthesia induction and 3 d after operation, there was no significant difference in MMSE score between the two groups(P>0.05). At 1 d, 2 d after surgery, the MMSE score in the study group was significantly higher than that in the control group(P<0.05). POCD incidence in the study group was significantly lower than that in the control group (P<0.05). There was no difference in hemodynamic indexes (HR, SBP, DBP) between the two groups before anesthesia induction(P>0.05). The HR, SBP and DBP in the study group were significantly lower than those in the control group at intubation, extubation and 15 min after extubation(P<0.05). The VAS pain scores in the study group were significantly lower than those in the control group at 1 h, 2 h, 6 h, 12 h and 24 h after operation(P<0.05). Conclusion: Dexmedetomidine can reduce the incidence of postoperative cognitive dysfunction, maintain the hemodynamic stability of patients, and has good analgesic effect, which is worthy of clinical application.