不同剂量右美托咪定对老年全身麻醉患者术后认知功能的影响

Effects of Different Doses of Dexmedetomidine on Postoperative Cognitive Function in Elderly Patients Undergoing General Anesthesia

目的旨在评估不同剂量右美托咪啶对老年全麻患者术后认知功能的影响。方法选取2022年3月—2023年9月于怀宁县人民医院接受全身麻醉的80例老年患者为研究对象,采用随机数表法分为3组,分别为对照组(20例)、A组(30例)和B组(30例)。对照组使用等剂量生理盐水泵入,A组泵入0.5μg/kg右美托咪啶,B组泵入1.0μg/kg右美托咪啶。对比分析3组的麻醉效果。结果术后24 h,A、B组的镇静评分较对照组高,且B组的(3.99±0.11)分高于A组的(2.51±0.91)分,差异有统计学意义(P均<0.05)。A、B组疼痛评分低于对照组,且B组的(0.70±0.09)分比A组的(0.91±0.28)分低,差异有统计学意义(P均<0.05)。术后6 h、1 d,A、B组的认知功能评分优于对照组,且B组高于A组,差异有统计学意义(P均<0.05)。术后即刻、1 d时,A、B组的磷脂酰肌醇3-激酶(Phosphatidylinositol 3-kinase,PI3K)、丝氨酸/苏氨酸激酶(Serine/threonine-protein ki⁃nase,AKT)水平均比对照组低,其中B组低于A组,差异有统计学意义(P均<0.05)。结论在老年全麻患者中,右美托咪定可显著改善患者的认知功能,发挥镇痛镇静效果,高剂量的右美托咪定对患者的认知能力有较好的保护作用。

Objective To assess the effects of different doses of dexmedetomidine on postoperative cognitive function of elderly general anesthesia patients.Methods A total of 80 elderly patients who received general anesthesia in Huaining County People's Hospital from March 2022 to September 2023 were selected as the study objects and were divided into 3 groups by random number table method:control group(20 cases),group A(30 cases)and group B(30 cases).Control group was pumped with an equal dose of saline,while group A was pumped with 0.5μg/kg dexmedeto⁃midine,and group B was pumped with 1.0μg/kg dexmedetomidine.The anesthetic effects of the three groups were compared and analyzed.Results 24 h after surgery,the sedation scores of groups A and B was higher than that of the control group,and the score of group B[(3.99±0.11)points]was higher than that of group A[(2.51±0.91)points],the difference was statistically significant(all P<0.05).The pain score of groups A and B was lower than that of control group,and the score of group B[(0.70±0.09)points]was lower than that of group A[(0.91±0.28)points],and the differ⁃ence was statistically significant(all P<0.05).At 6 h and 1 d after operation,the cognitive function scores of groups A and B were better than those of control group,and group B was higher than group A,the difference was statistically significant(all P<0.05).In the immediate postoperative period and 1 day later,the levels of phosphatidylinositol 3-ki⁃nase(PI3K)and serine/threonine-protein kinase(AKT)in groups A and B were lower than those in the control group,group B was lower than group A,and the differences were statistically significant(all P<0.05).Conclusion In elderly general anesthesia patients,dexmedetomidine can significantly improve the cognitive function of patients and exert an⁃algesic and sedative effects,and the high dose of dexmedetomidine has a better protective effect on the cognitive abil⁃ity of patients.