摘要
Abstract
Objective To investigate the influence of low-dose Ketamine assisted total intravenous anesthesia on postoperative cognitive function and inflammatory factors in elderly patients undergoing laparoscopic gallbladder surgery. Methods Eighty cases of elderly patients undergoing laparoscopic cholecystectomy from February 2015 to October 2015 were randomly divided into control group (total intravenous anesthesia) and observation group (low-dose Ketamine assisted total intravenous anesthesia). Anesthetic effect, cognitive function and levels of inflammatory cytokines were compared between the two groups. Results Ramsay sedation scores of the patients in the observation group were significantly lower than those in the control group at 10, 30 and 60 min after cessation of anesthetics ( < 0.05). The MMSE score of the patients in the observation group was significantly higher than that in the control group at 1 and 3 h after extubation, 1, 3 and 7 d after surgery ( < 0.05). The serum levels of inflammatory cytokines before skin incision and during cholecystectomy and at 30 min after extubation were all increased in the two groups, and the levels of inflammatory factors in the patients of the observation group were much lower than those of the control group at each time point ( <0.05). The incidences of delirium and cognitive dysfunction of the patients in the observed group were significantly lower than those in the control group 3 d after laparoscopic surgery ( < 0.05). The extubation time, the recovery time and the orientation recovery time in the observation group were significantly shorter than those in the control group ( < 0.05). The adverse response rates of the observation group and the control group (5% and 10 %) showed no significant difference (x2 = 0.72, > 0.05). Multiple linear regression analysis showed that the MMSE score was in linear regression relationships with TNF-α, IFN-γand IL-6 in patients ( < 0.05). Conclusions Low-dose Ketamine assisted total intravenous anesthesia in elderly patients undergoing laparoscopic cholecystectomy can effectively reduce postoperative cognitive dysfunction, inhibit release of inflammatory cytokines, maintain patient hemodynamic stability, obtain good anesthetic effect, and improve perioperative safety of the patients.关键词
氯胺酮/全凭静脉麻醉/腹腔镜胆囊术/认知功能/炎症因子Key words
Ketamine/total intravenous anesthesia/laparoscopic surgery/cognitive function/inflammatory cytokine分类
医药卫生
