摘要
目的:分析艾司氯胺酮麻醉诱导对老年全身麻醉患者术后谵妄的影响。方法:选取2020年3月—2022年7月昆明市中医医院接受非心血管手术且行全身麻醉的老年患者82例作为研究对象,根据随机数字表法分为试验组和对照组,各41例。试验组给予艾司氯胺酮麻醉诱导,对照组给予同等体积的0.9%氯化钠溶液。比较两组麻醉诱导前(t_(0))、插管前(t_(1))、插管即刻(t_(2))及插管后3 min(t_(3))时患者的心率(HR)及平均动脉压(MAP)情况,比较两组疼痛评分、谵妄、不良反应发生情况。结果:两组患者t_(0)、t_(1)及t_(3)时的HR及t_(0)、t_(1)及t_(2)时的MVP比较,差异无统计学意义(P>0.05);试验组t_(2)时HR低于对照组,试验组t_(3)时MVP高于对照组,差异有统计学意义(P<0.05);试验组各时间点HR及MAP比较,差异无统计学意义(P>0.05);对照组HR及MVP与同组内前一时间段数据比较,差异有统计学意义(P<0.05)。术后48 h内试验组疼痛评分低于对照组,差异有统计学意义(P<0.05);试验组谵妄发生率及恶心呕吐、头痛发生率低于对照组,差异有统计学意义(P<0.05)。结论:在老年患者全身麻醉中采用艾司氯胺酮进行麻醉诱导,有助于稳定术中血流动力学,降低术后疼痛程度,减少术后谵妄及不良反应。
Objective:To analyze the influence of esketamine-based anesthesia on postoperative delirium in elderly general anes⁃thesia patients.Methods:82 cases of elderly patients who underwent non-cardiovascular surgery with general anesthesia in Kun⁃ming Hospital of Traditional Chinese Medicine from March 2020 to July 2022 were selected as the study subjects,and were divided into the experimental group and the control group according to the method of random number table method,each with 41 cases.The experimental group was given esketamine for general anesthesia,and the control group was given the same volume of 0.9%sodium chloride solution.The heart rate(HR)and mean arterial pressure(MAP)of the patients in the two groups were compared in the fol⁃lowing time points:before anesthesia induction(t_(0)),before intubation(t_(1)),at the moment of intubation(t_(2)),and three minutes after in⁃tubation(t_(3));pain scores,delirium condition and the incidence of adverse reactions were compared also between the two groups.Re⁃sults:HR at t_(0),t_(1) and t_(3) and MVP at t_(0),t_(1) and t_(2) were compared between the two groups,and the difference was not statistically signifi⁃cant(P>0.05);HR at t_(2) in the experimental group was lower than that in the control group,and MVP at t_(3) in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05);the comparison of HR and MAP in the experimental group at each time point was not statistically significant(P>0.05);HR and MVP in the control group were com⁃pared with the data of the previous time period within the same group,and the difference was statistically significant(P<0.05).The pain level of the experimental group was lower than that of the control group in the postoperative period of 48 h,and the difference was statistically significant(P<0.05);the incidence of delirium and the incidence of nausea and vomiting and headache in the exper⁃imental group were lower than that of the control group,and the difference
作者
冯红坤
邓文芸
何恋
Feng Hongkun;Deng Wenyun;He Lian(Kunming Hospital of Traditional Chinese Medicine,Kunming 650011,Yunnan Province,China)
出处
《中外医药研究》
2023年第28期21-23,共3页
JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH
关键词
艾司氯胺酮
麻醉诱导
老年
全身麻醉
术后谵妄
Escitalopram
Anesthesia induction
Elderly
General anesthesia
Postoperative delirium
