摘要
Abstract
Objective In the present study,the author tries to explore the application of small doses of ket-amine after spinal anesthesia on the early postoperative cognitive dysfunction(POCD)of elder patients who received total hip replacement(THR)or total knee replacement(TKR).Method In the present research,60 elder patients who would receive elective THR under spinal anesthesia were selected and divided into two groups with 30 patients for each group.For the research group,subjects first received a dose of 0.2 mg/kg ketamine after spinal anesthesia and then a dose of 5 -10 μg·kg -1 · min -1 ketamine was continuously applied until the end of the operation while in the control group,the subjects received equal amount of normal saline.Then the MAP,HR and SPO2 at the following points were recorded:24h before the operation(T1),the moment of skin incision(T2),30min(T3),1h(T4),1.5h (T5),two hours(T6)and 24h(T7)after the operation.Besides,the adverse reactions during the perioperative period were also recorded and MMSE assessments at T1,T6 and T7 were conducted.The NSE (neural specific enolase)and S -10B serum concentration were also tested.Result Compared with the control group,the research group got high MMSE mark at T6,which mean that there was low POCD rate and low S -10B serum concentration.Conclusion Through this research,it is found that the application of small dose of ketamine after anesthesia on elder TKR/THR patients is safe and could effectively reduce POCD rate after 2 h of the operation.Even 24 h over the operation,the POCD condition for subjects in the research group is much better.关键词
麻醉,脊椎/氯胺酮/认知障碍/关节成形术,置换Key words
Anesthesia,Spinal/Ketamine/Cognition Disorders/Arthroplasty,Replacement分类
医药卫生
