纳布啡超前镇痛对老年全髋关节置换术患者血流动力学指标及认知功能的影响

Effect of nalbuphine preemptive analgesia on hemodynamic indexes and cognitive function in elderly patients undergoing total hip replacement

目的探讨纳布啡超前镇痛对老年全髋关节置换术患者血流动力学指标及认知功能的影响。方法选取2017年10月至2020年10月收治的80例老年全髋关节置换术患者,采用抽签法以单双号分组形式随机将其分为观察组和对照组,各40例。观察组在全身麻醉诱导前静脉注射纳布啡0.2 mg/kg,对照组在全麻诱导前静脉注射等量生理盐水。比较两组的镇痛效果、血流动力学指标及认知功能。结果术后2、6、12、24、48 h,观察组的VAS评分均低于对照组,差异具有统计学意义(P<0.05)。术后12、24 h,观察组的MAP、HR均低于对照组,差异具有统计学意义(P<0.05)。术后1、3 d,观察组的MMSE评分高于对照组,差异具有统计学意义(P<0.05)。结论纳布啡超前镇痛应用于老年管髋关节置换术患者中,有助于提高术后镇痛效果,减轻对术后认知功能的影响,也能促进其血流动力学改善,值得推广。

Objective To explore the effect of nalbuphine preemptive analgesia on hemodynamic indexes and cognitive function in elderly patients undergoing total hip replacement.Methods A total of 80 elderly patients undergoing total hip replacement admitted from October 2017 to October 2020 were selected and randomly divided into observation group and control group by lottery method and odd and even number grouping form,with 40 cases in each group.The observation group was intravenously injected with nalbuphine 0.2 mg/kg before general anesthesia induction,and the control group was intravenously injected with the same amount of normal saline before general anesthesia induction.The analgesic effects,hemodynamic indexes and cognitive function were compared between the two groups.Results At 2,6,12,24 and 48 h after operation,the VAS score of the observation group was lower than that of the control group,and the differences were statistically significant(P<0.05).At 12 and 24 h after operation,MAP and HR in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 1 and 3 d after operation,the MMSE score of the observation group was higher than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Nalbuphine preemptive analgesia applied in elderly patients undergoing total hip replacement can not only improve the postoperative analgesic effect,reduce the impact on postoperative cognitive function,but also promote the improvement of hemodynamics,which is worthy of popularization.