摘要
目的探讨布托啡诺对老年患者术后认知功能的影响。方法选取2018年1月~2019年3月于我院择期行经皮肾镜碎石取石术治疗的40例老年患者为研究对象,随机将其分为两组,每组20例。两组患者均用咪达唑仑、芬太尼、依托咪酯麻醉,患者意识消失后静脉推注苯磺顺阿曲库铵,气管插管成功后接通麻醉机进行机械通气,观察组患者在手术即刻加入布托啡诺,对照组患者不用布托啡诺,对两组患者各项指标及术后认知功能评分进行对比分析。结果两组患者的手术时间、麻醉时间、术后镇痛药物用量对比,差异无统计学意义(P>0.05);术后2h,观察组患者的术后认知障碍发生率明显低于对照组,两组对比有统计学差异(P<0.05),麻醉前1d、术后1d、术后3d对比均无统计学差异(P>0.05);两组患者麻醉前1d的认识功能评分对比无统计学差异(P>0.05),观察组患者术后2h、术后1d的认识功能评分均明显优于对照组,两组差异有统计学意义(P<0.05),两组术后3d的认知功能评分无统计学差异;两组不良反应发生率比较无统计学差异(P>0.05)。结论行经皮肾镜碎石取石术的老年患者采用布托啡诺诱导麻醉可降低术后认知障碍发生率,改善患者围术期认知功能,且安全性高,故值得进一步推广和应用。
Objective To explore the effect of butorphanol on postoperativecognitive function of elderly patients. Methods 40 elderly patients who underwent percutaneous nephrolithotomyin our hospital from January 2018 to March 2019 were selected as main research objects. They were randomly divided into two groups, with 20 cases in each group. The patients in both groups were anesthetized with midazolam, fentanyl and etomidate. After the patients’ consciousness disappeared, they were given the venous injection of cisastracuriumbesilate. After the tracheal intubation was successful, the anesthesia machine was turned on for mechanical ventilation. Patients in the observation group were given butorphanol immediately after surgery, and patients in the control group did not use butorphanol. The indexes and the postoperative cognitive function scores of patients of the two groups were compared and analyzed. Results There was no statistically significant difference in the operation time, anesthesia time and postoperative analgesic dosage between the two groups (P > 0.05). The incidence of postoperative cognitive impairment in the observation group was significantly lower than that in the control group at 2 hours after operation. There was statistically significant difference between the two groups (P < 0.05). There was no significant difference among 1 day before anesthesia, 1 day after anesthesia and 3 days after anesthesia (P > 0.05).There was no significant difference in the cognitive function scores between the two groups on 1 day before anesthesia (P > 0.05).The cognitive function scores of the observation group were significantly better than those of the control group at 2 h and 1 day after operation. The difference between the two groups was statistically significant (P < 0.05). There was no significant difference in cognitive function scores between the two groups on 3 days after operation. There was no significant difference between the two groups in the comparison of the incidence of adverse reactions (P > 0.05). Conclu
作者
巫浩彬
杨春艳
陈伟元
WU Haobin;YANG Chunyan;CHEN Weiyuan(Meizhou People's Hospital, Guangdong, Meizhou 514021, China)
出处
《中国医药科学》
2019年第13期33-35,38,共4页
China Medicine And Pharmacy
基金
广东省梅州市医药卫生科研课题(2018-B-12)
关键词
布托啡诺
老年患者
经皮肾镜碎石取石术
术后认知功能
Butorphanol
Elderly patients
Percutaneous nephrolithotomy
Postoperative cognitive function
