不同麻醉方式对髋关节置换术患者精神状态及认知功能的影响

Effects of various anesthesia methods on mental state and cognitive function in patients undergoing hiparthroplasty

目的 研究不同麻醉方式对髋关节置换术患者精神状态、认知功能及苏醒期躁动情况的影响.方法 选取我院麻醉科2020年6月~2022年6月期间110例行髋关节置换术患者,采用随机数字表法分为两组,对照组55例给予全身麻醉,观察组55例给予硬膜外复合全身麻醉,对比两组患者麻醉恢复情况、精神状态、术后苏醒期躁动情况和不良反应.结果 观察组苏醒时间、术后拔管时间、定向力恢复时间均低于对照组(P<0.05);观察组麻醉24h后,简易精神状态评价量表(MMSE)、神经行为认知状态检查表(NCSE)评分均高于对照组(P<0.05);观察组苏醒期躁动发生率低于对照组(P<0.05);两组患者心动过缓、低体温、恶心呕吐等不良反应发生率比较,差异无统计学意义(P>0.05).结论 硬膜外复合全身麻醉对髋关节置换术患者麻醉效果显著,能够缩短苏醒时间,保护患者精神状态和认知功能,降低苏醒期躁动发生率,安全性高.

Objective To study the effects of different anesthesia methods on mental state,cognitive function and waking agitation in patients with hip replacement.Methods A total of 110 patients who underwent hip replacement from June 2020 to June 2022 in the Department of Anesthesiology of our hospital of Pingdingshan were selected and di-vided into two groups by random number table method.55 patients in the control group received general anesthesia,and 55 patients in the observation group received epidural combined general anesthesia.Anesthesia recovery,mental state,restlessness and adverse reactions were compared between the two groups.Results The recovery time,postoperative extubation time and directional force recovery time of observation group were lower than those of control group(P<0.05).After 24h of anesthesia,the scores of MMSE and NCSE in observation group were higher than those in control group(P<0.05).The incidence of agitation in the observation group was lower than that in the control group(P<0.05).There was no significant difference in the incidence of bradycardia,hypothermia,nausea and vomiting between 2 groups(P>0.05).Conclusion Epidural combined general anesthesia has significant anesthetic effect on patients with hip replacement,which can shorten the recovery time,protect patients'mental state and cognitive function,reduce the incidence of agitation during recovery,and has high safety.