右美托咪啶联合七氟烷对腹腔镜手术患者麻醉效果及术后认知功能的影响分析

Effects of Dexmedetomidine Combined with Sevoflurane on Anesthesia and Postoperative Cognitive Function in Patients undergoing Laparoscopic Surgery

目的分析腹腔镜手术患者在采用七氟烷麻醉的前提下,联合应用右美托咪定的麻醉效果,以及该麻醉方案对术后认知功能障碍的预防价值。方法随机选取2022年1月—2023年3月福建省三明市尤溪县中医医院收治的90例腹腔镜手术患者为研究对象,以随机数表法分为对照组与观察组,每组45例。对照组的麻醉方案采用七氟烷,观察组在对照组用药的前提下,联合应用右美托咪定,比较两组麻醉效果、血流动力学指标、血清肾上腺素、去甲肾上腺素、皮质醇水平、认知功能。结果与对照组相比,观察组术后清醒时间、首次呼吸时间、定向力恢复时间均更短,差异有统计学意义(P均<0.05)。相比于术前,对照组患者术后6 h、术后12 h的血流动力学指标及肾上腺素、去甲肾上腺素、皮质醇水平均明显降低,差异有统计学意义(P均<0.05);对照组术后6 h、术后12 h的血流动力学指标及肾上腺素、去甲肾上腺素、皮质醇水平均明显低于观察组,差异有统计学意义(P均<0.05)。术后1 d,观察组认知功能评分显著高于对照组,差异有统计学意义(P<0.05)。结论在腹腔镜手术患者中联合应用七氟烷与右美托咪定能取得较好的麻醉效果,明显减少术后认知功能障碍。

Objective To analyze the anesthetic effect of combined dexmedetomidine in laparoscopic patients with sevoflurane anesthesia,and the preventive value of this anesthesia program on postoperative cognitive dysfunction.Methods A total of 90 laparoscopic surgery patients admitted to Youxi County Traditional Chinese Medicine Hospital in Sanming City at Fujian Province from January 2022 to March 2023 were randomly selected as the study objects and divided into control group and observation group by random number table method,with 45 cases in each group.Sevo⁃flurane was used in the control group,and dexmedetomidine was used in the observation group in combination with the control group.Anesthetic effect,hemodynamic indexes,serum epinephrine,norepinephrine,cortisol levels and cog⁃nitive function were compared between the two groups.Results Compared with the control group,the observation group was shorter in terms of postoperative waking time,first breathing time and orientation recovery time,and the dif⁃ferences were statistically significant(all P<0.05).Compared with before surgery,the hemodynamic indexes and the levels of epinephrine,norepinephrine and cortisol in control group at 6 h and 12 h after surgery were significantly de⁃creased,and the differences were statistically significant(all P<0.05).The hemodynamic indexes and the levels of epi⁃nephrine,norepinephrine and cortisol in control group at 6 h and 12 h after surgery were significantly lower than those in observation group,and the differences were statistically significant(all P<0.05).On the first day after operation,the cognitive function score of the observation group was significantly higher than that of the control group,and the differ⁃ence was statistically significant(P<0.05).Conclusion The combination of sevoflurane and dexmedetomidine in patients undergoing laparoscopic surgery can achieve better anesthetic effects and significantly reduce postoperative cog⁃nitive dysfunction.