不同剂量氯胺酮复合地佐辛对老年腹腔镜胆囊术患者术后认知功能的影响研究

Study on the Influence of Different Doses of Ketamine Combined with Dezocine on Postoperative Cognitive Function in Elderly Patients with Laparoscopic Cholecystectomy

目的探讨不同剂量氯胺酮复合地佐辛对老年腹腔镜胆囊术患者术后认知功能的影响。方法选取2018年9月至2020年12月我院收治的92例老年腹腔镜胆囊术患者,按抽签法平均分为两组。参照组采用常规剂量氯胺酮复合地佐辛进行术后镇痛,研究组采用小剂量氯胺酮复合地佐辛进行术后镇痛,对比两组术后认知功能障碍(POCD)发生率、苏醒时间及不同时间点的疼痛程度、认知功能。结果研究组POCD发生率低于参照组,苏醒时间短于参照组(P<0.05)。用药后1 d、3 d,两组的VAS评分比较无统计学差异(P>0.05),而研究组的MMSE评分高于参照组(P<0.05)。结论小剂量氯胺酮复合地佐辛可有效改善老年腹腔镜胆囊术患者术后认知功能,减少POCD的发生,促进患者意识恢复,且不会影响镇痛效果。

Objective To explore the influence of different doses of ketamine combined with dezocine on postoperative cognitive function in elderly patients with laparoscopic cholecystectomy.Methods 92 elderly patients with laparoscopic cholecystectomy admitted to our hospital from September 2018 to December 2020 were selected and divided into two groups by lotting equally.The reference group was given routine-dose ketamine combined with dezocine for postoperative analgesia,and the study group was given low-dose ketamine combined with dezocine for postoperative analgesia.The incidence of postoperative cognitive dysfunction(POCD),wake-up time,and the pain degree and cognitive function at different time points were compared between the two groups.Results The incidence of POCD in the study group was lower than that in the reference group,and the wake-up time was shorter than that in the reference group(P<0.05).1 day and 3 days after medication,no statistical difference was found in the VAS scores between the two groups(P>0.05),and the MMSE scores of the study group were higher than those of the reference group(P<0.05).Conclusions Low-dose ketamine combined with dezocine can effectively improve the postoperative cognitive function in elderly patients with laparoscopic cholecystectomy,reduce the POCD,and promote patients'consciousness recovery,without affecting the analgesic effect.