右美托咪定对老年肺癌根治术患者苏醒质量和术后认知功能的影响

Effects of dexmedetomidine on post-anesthesia recovery and postoperative cognitive dysfunction in elderly patients receiving lung resection

目的探讨右美托咪定对老年肺癌根治术患者苏醒质量和术后认知功能的影响。方法选择50例美国麻醉医师协会Ⅰ～Ⅱ级肺癌根治术患者，均在复合麻醉下手术，根据随机数字表法分为研究组和对照组，各25例。研究组在诱导前20 min静脉匀速泵注右美托咪定1 μg/kg，诱导后调整速率至0.3 μg/（kg·h），术毕前30 min停止输注；对照组静脉泵注同等剂量的0.9%氯化钠注射液。观察2组患者麻醉苏醒质量和术后认知功能情况。结果研究组术后呛咳和躁动评分明显低于对照组[（2.4±0.7）分比（2.8±0.7）分，（1.6±0.5）分比（2.0±0.6）分，均P〈0.05]，呼吸恢复时间、拔管时间和苏醒时间与对照组比较差异无统计学意义[（11.2±1.6）min比（10.4±1.5）min，（14.7±2.8）min比（13.3±3.4）min，（14.9±2.9）min比（14.1±2.9）,均P＞0.05]。2组术前和术后48 h简易精神状态检查量表评分差异无统计学意义（P〉0.05），研究组术后12、24 h简易精神状态检查量表评分明显高于对照组[术后12、24 h分别为（25.9±1.2）分比（24.2±1.3）分，（28.0±0.8）分比（26.7±1.0）分,均P〈0.05）。结论右美托咪定可明显改善老年肺癌根治术患者苏醒质量和术后早期认知功能。

ObjectiveTo investigate the effects of dexmedetomidine on the quality of postanesthesia recovery and postrperativecognitive dysfunction in elderly patients after lung resection. MethodsFifty elderly patients had lung resection. American Society of AnesthesiologistsⅠⅡand intravenous anesthesia combined with inhalation anesthesia were randomly divided into study group and control group according to the random number table, with 25 cases in each group. Dexmedetomidine 1 μg/kg was infused within 20 min before induction in study group, then it was adjusted to the rate of 0.3 μg/（kg·h） after induction. The infusion of dexmedetomidine was stopped 30 min before surgery completed. The control group received intravenous infusion of saline. The quality of postanesthesia recovery and postoperative cognitive dysfunction were observed in two groups. ResultsThe scores of cough and agitation in study group were significantly lower than those in the control group [（2.4±0.7）scores vs （2.8±0.7）scores, （1.6±0.5）scores vs （2.0±0.6）scores, P〈0.05]. There were no significantly differences in breathing recovery time, extubation time and recovery time in two goups（P〉0.05）. There was no significant difference in MiniMental State Examination （MMSE） score in two groups before surgery and postoperative 48 h（P〉0.05）. MMSE scores at 12 h, 24 h after operation in study group were significantly higher than those in control group ／[ （25.9±1.2）scores vs （24.2±1.3）scores and （28.0±0.8）scores vs （26.7±1.0）scores, P〈0.05／].ConclusionDexmedetomidine can significantly improve the quality of postanesthesia recovery and early postoperative cognitive dysfunction.