纳美芬超前镇痛对老年关节置换术后患者早期认知功能的影响

The early cognitive function effects of Nalmefene preemptive analgesia for joint replacement elderly patients

目的探讨纳美芬超前镇痛对老年关节置换患者早期认知功能的影响。方法将80例行关节置换术老年患者随机分成治疗组与对照组,各40例,治疗组采用纳美芬超前镇痛,对照组采用纳洛酮超前镇痛。结果治疗组各时点心率(HR)和平均动脉压(MAP)变化差异无统计学意义(P>0.05)。对照组手术时、拔管时较麻醉前、镇痛时及治疗组,HR明显增快,MAP明显升高(P<0.05)。治疗组的术后睁眼时间和拔管时间都明显少于对照组(P<0.05)。治疗组治疗后的HAMD总分、焦虑/躯体化、认识障碍得分比治疗前低(P<0.05),对照组无明显变化(P>0.05)。结论纳美芬超前镇痛应用于老年关节置换患者中,易于维持血流动力学稳定,同时利于早期认知功能的恢复,值得推广应用。

Objective To investigate the early cognitive function effects of Nalmefene preemptive analgesia for joint replacement elderly patients. Methods 80 elderly patients with joint replacement were randomly divided into treatment group and control group, each for 40 cases, the treatment group were given the Nalmefene preemptive analgesia, and the control group were given Naloxone preemptive analgesia. Results The heart rate （HR） and mean arterial pressure （MAP） changes at each time point in treatment group had no significant differences （P 〉 0.05）, but had significant differences （P 〈 0.05） in the control group of surgery, before extubation compared to anesthesia, analgesia time （P 〈 0.05）. The opening eyes and extubation time of the treatment group were significantly less than the control group （P 〈 0.05）. The HAMD total score, anxiety/somatization, recognizing obstacles score of the treatment group were lower than the control group after treatment （P 〈 0.05）. Conclusion Nalmefene preemptive analgesia in elderly patients with joint replacement can maintain hemodynamic stability, it is conducive to the early recovery of cognitive function that should be widely applied.