摘要
目的探究七氟烷联合罗哌卡因浸润麻醉对老年食管癌患者术后镇痛效果、认知功能和炎性因子的影响。方法纳入本院在2019年1月至2022年1月收治的行手术的食管癌患者142例。采用随机数字表法分为联合组(71例,给予1%~3%七氟烷麻醉联合罗哌卡因浸润麻醉)和七氟烷组(71例,给予1%~3%七氟烷麻醉维持)。比较两组患者术后镇痛效果、认知功能、炎性因子水平。结果两组术后12 h、术后1 d、术后3 d视觉模拟评分法(VAS)评分均降低,联合组下降更明显(P<0.05);两组术前1 d、术后12 h、术后1 d、术后3 d简易智能状态检查量表(MMSE)评分先下降后上升(P<0.05);IL-6、TNF-ɑ、IL-1β水平先上升后下降(P<0.05)。联合组术后12 h、术后1 d、术后3 d的MMSE评分高于七氟烷组(P<0.05),VAS评分及IL-6、TNF-ɑ、IL-1β水平低于七氟烷组(P<0.05)。结论七氟烷联合罗哌卡因浸润麻醉更有利于降低食管癌患者术后炎症因子水平,对患者术后认知功能损害小,镇痛效果好。
Objective To investigate the influences of sevoflurane combined with ropivacaine infiltration anesthesia on analgesic effect,cognitive function and inflammatory factors in elderly patients with esophageal cancer after operation.Methods 142 patients with esophageal cancer who underwent surgery in our hospital from January 2019 to January 2022 were included.They were randomly divided into the combined group(71 cases,1%~3%sevoflurane anesthesia combined with ropivacaine infiltration anesthesia)and the sevoflurane group(71 cases,1%~3%sevoflurane anesthesia maintenance).The analgesic effect,cognitive function and inflammatory factor level were compared between the two groups.Results The visual analogue pain scale(VAS)scores in both groups decreased at 12 h,1 d and 3 d after operation,especially in the combined group(P<0.05).In both groups,the score of the minimental state estimate(MMSE)was firstly decreased and then increased at before operation 1 d and 12 h,1 d and 3 d after operation(P<0.05).The levels of IL-6,TNF-ɑ,IL-1βwere increased and then decreased(P<0.05).The MMSE scores 12 h,1 d and 3 d after surgery in combination group were higher than those in sevoflurane group(P<0.05),and VAS scores and IL-6,TNF-alpha and IL-1βlevels in combination group were lower than those in sevoflurane group(P<0.05).Conclusion Sevoflurane combined with ropivacaine infiltration anesthesia is more beneficial to reduce the level of inflammatory factors in patients with esophageal cancer after surgery,with less damage to cognitive function and better analgesic effect.
作者
杨斌
杨旭明
YANG Bin;YANG Xu-ming(Department of Oncology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang,China,471003)
出处
《食管疾病》
2023年第1期19-22,32,共5页
Journal of Esophageal Diseases
关键词
七氟烷
罗哌卡因
老年
食管癌
认知功能障碍
炎性因子
sevoflurane
ropivacaine
old age
esophageal cancer
cognitive dysfunction
inflammatory factor
