依托咪酯联合硬膜外麻醉对老年子宫切除患者MMSE评分的影响

Effects of etomidate combined with epidural anesthesia on MMSE scores in elderly patients with hysterectomy

目的探究依托咪酯联合硬膜外麻醉对老年子宫切除患者简易智能精神状态检查量表(mini-mental state examination,MMSE)评分的影响。方法选取2018年8月至2019年9月本院收治的30例老年子宫切除患者作为研究对象,按照随机数字表法分为对照组与观察组,每组30例。对照组实施依托咪酯全麻,观察组实施依托咪酯联合硬膜外麻醉,比较两组MMSE评分及用药量。结果术前24 h、术后第3天、术后第7天,两组MMSE评分比较差异无统计学意义;术后第1天,观察组MMSE评分明显高于对照组(P<0.05)。两组阿托品、麻黄碱用量比较差异无统计学意义;观察组依托咪酯乳剂总量低于对照组(P<0.05)。结论老年子宫切除患者实施依托咪酯联合硬膜外麻醉,对患者早期认知功能影响较小,且可减少阿托品、麻黄碱用量,效果显著,值得临床推广应用。

Objective To study the effect of etomidate combined with epidural anesthesia on the mini-mental state examination(MMSE)score in elderly patients with hysterectomy.Methods 30 elderly hysterectomy patients admitted to our hospital from August 2018 to September 2019 were selected as the research subjects,and they were divided into control group and observation group according to random number table method,with 30 cases in each group.The control group was given etomidate general anesthesia,and the observation group was given etomidate combined with epidural anesthesia.The MMSE scores and dosage between the two groups were compared.Results There was no statistically significant difference in MMSE scores between the two groups at 24 h before operation,on the 3 d after the operation,and on the 7 d after the operation;on the 1 d after the operation,the MMSE score of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the dosage of atropine and ephedrine between the two groups;the total amount of etomidate emulsion in the observation group was lower than that in the control group(P<0.05).Conclusion Etomidate combined with epidural anesthesia for elderly patients undergoing hysterectomy has little effect on the early cognitive function of patients,and can reduce the dosage of atropine and ephedrine.The effect is significant and it is worthy of clinical application.