右美托咪定对老年腹腔镜卵巢癌根治术患者术后苏醒与认知功能的影响研究

Effects of dexmedetomidine on postoperative recovery and cognitive function of elderly patients undergoing laparoscopic radical surgery for ovarian cancer

目的探讨右美托咪定对老年腹腔镜卵巢癌根治术患者术后苏醒与认知功能的影响。方法选取全身麻醉气管插管下行腹腔镜卵巢癌根治术的100例老年患者,按照随机数字表法分为观察组和对照组,每组50例。对照组患者使用咪达唑仑麻醉镇静,观察组患者使用右美托咪定麻醉镇静,比较麻醉拔管时两组患者的血浆S-100B蛋白、NSE水平,术后6 h ESS、MMSE评分,麻醉苏醒时间、麻醉拔管时间、复苏室停留时间及围麻醉期术中知晓、术后认知功能障碍的发生情况。结果麻醉拔管时,观察组患者的血浆S-100B蛋白、NSE水平均明显低于对照组;术后6 h,观察组患者的ESS、MMSE评分均明显高于对照组;观察组麻醉苏醒时间、麻醉拔管时间、复苏室停留时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。观察组患者术中知晓、术后认知功能障碍的发生率均低于对照组,差异均有统计学意义(P﹤0.05)。结论围麻醉期使用右美托咪定,可以有效地促进老年腹腔镜卵巢癌根治术患者的麻醉苏醒,减少认知功能障碍的发生率。

Objective To investigate the effect of dexmedetomidine on the postoperative recovery and cognitive function of elderly patients undergoing laparoscopic radical surgery for ovarian cancer. Method One hundred patients underwent laparoscopic radical surgery for ovarian cancer were randomly divided into two groups, each included 50 patients.All patients received general anesthesia tracheal intubation, the sedative drug for control group was midazolam, while the sedative drug for observation group was dexmedetomidine. The plasma S-100 B protein and NSE levels at anesthesia extubation; the ESS and MMSE scores at 6 h after the surgery; and the recovery time of anesthesia, the extubation time of anesthesia and the residence time in the resuscitation chamber were compared between the two groups. The incidences of intraoperative awareness during the anesthesia and postoperative cognitive dysfunction were compared between the two groups. Result The levels of S-100 B protein and NSE at anesthesia extubation in the observation group were significantly lower than those in the control group and the ESS and MMSE scores at 6 h after surgery in the observation group were significantly better than those in the control group; the anesthesia recovery time, anesthesia extubation time and residence time in the resuscitation chamber in the observation group were significantly shorter than those in the control group, the differences were statistically significant（P〈0.01）. The incidences of intraoperative awareness during the anesthesia and postoperative cognitive dysfunction in the observation group were lower than those in the control group, the differences were statistically significant（P〈0.05）. Conclusion The use of dexmedetomidine in the anesthesia period can effectively promote the recovery of anesthesia in elderly patients undergoing laparoscopic radical surgery for ovarian cancer and reduce the incidence of cognitive dysfunction.