汉族与哈萨克族产妇剖宫产术后镇痛泵应用右美托咪定对其认知功能的影响

Effects of dexmedetomidine analgesic pump on cognitive function of Han and Kazakh women after caesarean section

目的探究汉族与哈萨克族产妇剖宫产术后镇痛泵应用右美托咪定对其认知功能的影响。方法选取拟于本院行硬膜外麻醉剖宫产术的汉族与哈萨克族产妇120例为研究对象,按照随机数字表法分为对照组及研究组。对照组60例中有汉族39例、哈萨克族21例;研究组60例中有汉族40例、哈萨克族20例。对照组采用常规麻醉及术后镇痛,研究组在此基础上在术后镇痛中使用右美托咪定。对比两组及组内不同民族产妇的术后疼痛情况、认知功能及术后认知功能障碍(POCD)发生率。结果术后镇痛1、8、24、48 h,研究组疼痛视觉模拟评分(VAS)均低于对照组,且两组内汉族产妇VAS评分均低于哈萨克族,差异有统计学意义(P<0.05)。两组T。时简易智力状态检查量表(MMSE)评分比较,差异无统计学意义(P>0.05);研究组T_(1)、T_(2)时MMSE评分均高于对照组,差异有统计学意义(P<0.05)。研究组POCD总发生率为11.67%(7/60),低于对照组的1.67%(1/60),差异有统计学意义(P<0.05)。两组内汉族与哈萨克族各时段MMSE评分及POCD发生率比较,差异无统计学意义(P>0.05)。结论剖宫产术后镇痛泵应用右美托咪定可有效缓解产妇疼痛,降低POCD发生率;哈萨克族与汉族产妇的术后认知功能无明显差异,但哈萨克族产妇的疼痛敏感性更高。

Objective To explore the effects of dexmedetomidine on cognitive function after caesarean section in Han and Kazakh women. Methods A total of 120 pregnant women of Han nationality and Kazak nationality who planned to undergo epidural caesarean section in our hospital were selected as the research objects and were divided into a control group and a study group according to random number table method. In the 60 cases of control group, 39 cases were Han nationality and 21 cases were Kazak nationality. In the 60 cases of study group, 40 cases were Han nationality and 20 cases were Kazak nationality. The control group received conventional anesthesia and postoperative analgesia, and the study group received dexmedetomidine on the basis of postoperative analgesia. The postoperative pain, cognitive function and incidence of postoperative cognitive dysfunction(POCD)were compared between the two groups and different ethnic groups. Results 1, 8, 24, 48 hours after postoperative analgesia, the pain visual analogue scale(VAS) scores of the study group were lower than those of the control group, and the VAS scores of the Han women in the two groups were lower than those of the Kazakh, the differences were statistically significant(P<0.05). There was no significant difference in simple mental state examination scale(MMSE) scores between the two groups at T0(P>0.05);MMSE scores in the study group were higher than those in the control group at T1and T2, and the differences were statistically significant(P<0.05). The total incidence of POCD in the study group was 11.67%(7/60), lower than 1.67%(1/60) in the control group, and the difference was statistically significant(P<0.05). There were no significant differences in MMSE scores and POCD incidence between Han and Kazakh groups(P>0.05). Conclusion Using dexmedetomidine analgesic pump after cesarean section can effectively relieve pain and reduce the incidence of POCD. There was no significant difference in postoperative cognitive function between Kazakh and Han mothers, but Kazakh mothers were more sensitive to pain.