右美托咪定对全身麻醉老年患者术后苏醒期躁动及早期认知功能的影响

Influences of Dexmedetomidine on the Early Cognitive Function and Postoperative Agitation in the Stage of Analepsia in Elderly Patients with General Anesthesia

目的:探讨右美托咪定对全身麻醉老年患者术后苏醒期躁动及早期认知功能的影响。方法:收集符合标准的患者60例,采用随机数字表法分为观察组和对照组各30例,均给予相同的麻醉,观察组加用右美托咪定,对照组加用等体积的0.9%氯化钠注射液,观察麻醉苏醒期躁动及术后认知功能。结果:两组手术时间、麻醉时间及自主呼吸恢复时间相似,差异无统计学意义(P>0.05),但苏醒时间观察组明显缩短,差异有统计学意义(P<0.05)。观察组苏醒期躁动发生率16.67%,明显低于对照组的53.33%,差异有统计学意义(P<0.05)。术后1d、术后7d,观察组术后认知功能障碍发生率为13.33%、3.33%,低于对照组的30.00%、16.67%,差异有统计学意义(P<0.05)。结论:右美托咪定能有效预防全身麻醉老年患者术后苏醒期躁动,减轻麻醉对患者认知功能的影响。

Objective ： To investigate the effects of dexmedetomidine on the early cognitive function and postoperative agitation in the stage of analepsia in old patients with general anesthesia. Methods： A total of 60 eligible patients were collected and randomly divided into observation group and control group, with 30 patients in each group. All the patients were given the same anesthesia, and the observation group used dexme- detomidine additionally, while the control group used the same volume of 0.9% sodium chloride injection. The postoperative cognitive function and agitation in the stage of analepsia after anesthesia were observed. Results ： The two groups had insignificantly different operative times, anesthesia times, and times to recovery of spontaneous breathing （P 〉0.05） ; but the observation group had significantly shorter analepsia time than those in control group （ P〈0.05 ）. The incidence of agitation in the stage of analepsia of the observation group was 16. 67%, and was significantly lower than that of the control group （53.33% ） （P〈0.05）. On ld and 7d after the surgeries, the incidences of postoperative cognitive dysfunction of the observation group were 13.33% and 3. 33%, respectively, and were significantly lower than those of the control group （30.00% and 16.67%, respectively） （P〈0.05）. Conclusion： Dexmedetomidine can effectively prevent from postoperative agitation in the stage of analepsia and lighten the effects of the anesthesia on the cognitive function in old patients with general anesthesia.