右美托咪啶对老年椎管内麻醉腹部手术患者术后早期认知功能的影响

Effect of dexmedetomidine on early cognitive function in elderly patients undergoing abdominal surgery under spinal anesthesia

目的探究右美托咪啶对老年椎管内麻醉下行腹部手术患者术后早期认知功能的影响。方法选取2016年8月-2017年11月该院行腹部手术的老年患者90例作为研究对象,按照随机数字表法分为两组,各45例。观察组于麻醉诱导前给予静脉泵注右美托咪啶,对照组则泵注0.9%NaCl注射液;对比两组术前、术后1 d、术后2 d认知功能水平及不良反应发生情况。结果两组患者术前认知功能评分比较差异无统计学意义(P>0.05),与对照组相比,观察组术后1 d、术后2 d认知功能评分、心动过缓发生率较高,恶心呕吐发生率较低,差异均有统计学意义(P<0.05)。结论老年椎管内麻醉下行腹部手术患者术前给予右美托咪啶泵注具有较好的镇静作用,利于患者认知功能的恢复,减少认知功能障碍发生率,且药物具有较高的安全性,值得临床推广应用。

【Objective】To investigate the effect of dexmedetomidine on early postoperative cognitive function in elderly patients undergoing abdominal surgery under spinal anesthesia.【Methods】A total of 90 elderly patients who underwent abdominal surgery in our hospital from August 2016 to November 2017 were enrolled in the study.They were divided into two groups according to the random number table method,45 cases each.The observation group was given intravenous dexmedetomidine before induction of anesthesia,while the control group was pumped with 0.9%NaCl injection.The cognitive function and adverse reactions were compared before operation,1 day after operation and 2 days after operation.【Results】There was no significant difference in preoperative cognitive function scores between the two groups(P>0.05).Compared with the control group,the observation group had higher cognitive function score and bradycardia 1 day after operation and 2 days after operation.The incidence of nausea and vomiting was low,and the difference was statistically significant(P<0.05).【Conclusion】Preoperative dexmedetomidine pumping in patients undergoing abdominal surgery under spinal anesthesia has a good sedative effect,which is beneficial to the recovery of cognitive function and reduction of the incidence of cognitive dysfunction,the drug has high safety,so it is worthy of clinical application.