低剂量艾司氯胺酮对老年妇科手术患者全麻苏醒期躁动及术后认知功能的影响

Effects of low-dose esketamine on agitation during recovery from general anesthesia and postoperative cognitive function in elderly gynecological surgery patients

目的 分析应用低剂量艾司氯胺酮对接受妇科手术的老年患者全麻苏醒期躁动(EA)及认知功能的影响。方法筛选80例全麻下行妇科手术的老年患者,按随机数字表法分为研究组(40例,低剂量艾司氯胺酮)和对照组(40例,等量生理盐水)。对比两组各项指标。结果 研究组躁动发生率、躁动评分均显著低于对照组;研究组T1~T4简易精神状态检查量表评分高于对照组;研究组认知功能障碍发生率显著低于对照组;T3时研究组血清神经元特异性烯醇化酶及中枢神经特异性蛋白水平显著低于对照组,差异有统计学意义(P<0.05)。结论 对于全麻下行妇科手术的老年患者,选择低剂量艾司氯胺酮进行麻醉可减少EA的发生,减轻脑损伤,并有利于改善患者术后短期认知功能。

Objective To analyze the effect of low-dose esketamine on agitation(EA) and cognitive function during recovery from general anesthesia in elderly patients undergoing gynecological surgery. Methods A total of 80 elderly patients undergoing gynecological surgery under general anesthesia were screened and divided into the study group(40 cases, low-dose esketamine)and the control group(40 cases, equal volume of normal saline) according to the random number table method. The two groups of indicators were compared. Results The incidence of agitation and agitation score in the study group were significantly lower than those in the control group. The T~Tsimple mental state examination scale scores in the study group were higher than those in the control group. The incidence of cognitive impairment in the study group was significantly lower than that in the control group. At T,the serum levels of neuron-specific enolase and CNS-specific protein in the study group were significantly lower than those in the control group, and the difference was statistically significant(P<0.05). Conclusion For elderly patients undergoing gynecological surgery under general anesthesia, choosing low-dose esketamine for anesthesia can reduce the occurrence of EA, reduce brain damage, and improve short-term postoperative cognitive function.