右美托咪定在老年经皮椎间孔镜椎间盘切除术中的应用

The Effect of Dexmedetomidine in Elderly Patients Undergoing Endoscopic Surgery

目的观察不同剂量右美托咪定在老年经皮椎间孔镜椎间盘切除术(percutaneous transforaminal endoscopic discectomy,PTED)中的镇静镇痛及对患者认知功能障碍的影响。方法纳入我院2016年1月—2018年8月进行PTED的老年患者分为五组各25例,分别为不采用、0.2、0.3、0.4、0.5μg/(kg·h)右美托咪定,观察患者的VAS评分、OAA/S评分及MMSE评分。结果五组患者T1时间点的VAS评分和OAA/S评分对比差异均无统计学意义(P> 0.05),在T2时间点,VAS均出现上升,后出现下降,OAA/S评分出现下降,后出现上升,E组的T2和T3时间点的VAS评分和OAA/S评分均低于其余四组(P<0.05)。在术后3d,五组患者的MMSE评分均得到下降,E组的下降较其余四组减少,差异具有统计学意义(P <0.05)。结论 PTED患者输注右美托咪定0.5μg/(kg·h)可有效的改善患者的镇静镇痛效果及认知功能障碍。

Objective To observe the effects of different doses of dexmedetomidine on sedation and analgesia in elderly patients with intervertebral foramen(PTED)and cognitive dysfunction.Methods Elderly patients enrolled in our hospital from January 2016 to August 2018 were divided into five groups,25 patients in each group,respectively,without dexmedetomidine,0.2,0.3,0.4,0.5μg/(kg·h),the patient's VAS score,OAA/S score and MMSE score were observed.Results There was no significant difference in VAS scores and OAA/S scores between the five groups at the T1 time point(P>0.05).At the T2 time point,VAS increased,then decreased,and the OAA/S score decreased.The VAS score and OAA/S score at the T2 and T3 time points in the E group were lower than those in the other four groups(P<0.05).At 3 days after surgery,the MMSE scores of the five groups were decreased,and the decrease of the E group was lower than that of the other four groups,the difference was statistically significant(P<0.05).Conclusion Infusion of dexmedetomidine 0.5μg/(kg·h)in patients with PTED can effectively improve the sedative and analgesic effects and cognitive dysfunction in patients.