解放军医药杂志2017，Vol.29Issue(11)：84-88,5.DOI:10.3969/j.issn.2095-140X.2017.11.022
瑞芬太尼复合丙泊酚对老年骨科手术患者术中应激反应和术后认知功能的影响
Effects of Remifentanil Combined with Propofol on Intraoperative Stress Reaction and Postoperative Cognitive Function of Elderly Patients Undergoing Orthopedic Surgery
摘要
Abstract
Objective To investigate effect of intravenous anesthesia by Remifentanil combined with Propofol on intraoperative stress reaction and postoperative cognitive function of elderly patients undergoing orthopedic surgery.Methods A total of 86 elderly patients undergoing orthopedic surgery during October 2015 and November 2016 were divided into control group (n =43) and study group (n =43) according to different medication.Control group was treated with Fentanyl combined with Propofol,while study group was treated with Remifentanil combined with Propofol.Streess reactions were compared before anesthesia induction (T0),2 min after anesthesia induction (T1),immnediately after intubation (T2),immediately before extubation (T3),immediately after extubation (T4) and after surgery (T5) between two groups,and postoperative mini-mental state examination (MMSE) score and incidence rate of postoperative cognitive dysfunction (POCD) were compared,and condition of consciousness recovery was compared after stopping anesthesia between the two groups.Results In study group,levels of mean arterial pressure at T4 and T5 were significantly lower (P ＜ 0.05),and cortisol levels at T1-T5 were significantly lower (P ＜ 0.05),and heart rate at T5 was significantly lower than those in control group (P ＜ 0.01).MMSE scores in postoperative 1,4 and 8 h in study group were significantly higher than those in control group (P ＜ 0.01).Times of breathing recovery,opening eyes,extubation and talking were significantly shorter in study group than those in control group (P ＜ 0.05).Incidence rates of POCD were significantly lower in postoperative 1,4,8 and 12 h in study group than those in control group (P ＜0.05).Conclusion Remifentanil combined with Propofol in application of anesthesia for elderly patients undergoing orthopedic surgery may effectively inhibit stress reaction during operation with little effect on postoperative cognitive function.关键词
骨科手术/老年人/瑞芬太尼/丙泊酚/应激/术后认知功能障碍Key words
Orthopedic surgery/Aged/Remifentanil/Propofol/Stress/Postoperative cognitive dysfunction分类
医药卫生引用本文复制引用
张庆华,马鑫笛,廖华山,王伟卓..瑞芬太尼复合丙泊酚对老年骨科手术患者术中应激反应和术后认知功能的影响[J].解放军医药杂志,2017,29(11):84-88,5.基金项目
国家自然科学基金(81001225) （81001225）
