不同七氟烷洗脱方法对髋关节置换老年肥胖患者苏醒质量及认知功能的影响OACSTPCD
Effects of different sevoflurane elution methods on awakening quality and cognitive function of elderly obese patients undergoing hip joint replacement
目的 探讨不同七氟烷洗脱方法对髋关节置换老年肥胖患者苏醒质量及认知功能的影响.方法 选取在静吸复合全身麻醉下行髋关节置换且术中使用七氟烷进行麻醉维持的老年肥胖患者90例为研究对象,随机分为A组和B组,分别使用闭合洗脱法及浓度递减洗脱法洗脱七氟烷.比较2组患者在不同时刻呼出七氟烷的浓度及认知功能评分.比较2组患者的苏醒质量及苏醒期不良反应发生情况.结果 手术结束时,B组患者呼出七氟烷的浓度显著低于A组(P<0.05),B组患者体动恢复时间、苏醒时间、气管拔管时间及麻醉恢复室停留时间均明显短于A组(P<0.05).B组患者苏醒期躁动发生率显著低于A组(P<0.05),在苏醒后2 h,A组患者认知功能评分显著低于B组(P<0.05).结论 对于静吸复合全身麻醉下行髋关节置换的老年肥胖患者,手术结束前使用浓度递减洗脱法洗脱七氟烷,患者苏醒平稳且时间较短,不良反应少,术后认知功能受影响小.
Objective To explore the effects of different sevoflurane elution methods on awakening quality and cognitive function of elderly obese patients undergoing hip joint replacement.Methods A total of 90 elderly obese patients underwent hip joint replacement under intravenous inhalation combined with general anesthesia and maintained anesthesia with sevoflurane during surgery were selected as the research subjects,and randomly divided into group A and group B,and sevoflurane was eluted by closed elution method and decreasing concentration elution method,respectively.The concentration of sevoflurane exhaled and cognitive function scores at different time points of patients between the two groups were compared,and the awakening quality and the occurrence of adverse reactions during the awakening period of patients between the two groups were compared.Results At the end of the surgery,the concentration of sevoflurane exhaled by patients in group B was significantly lower than that in group A(P<0.05),and the recovery time,awakening time,tracheal extubation time,and anesthesia recovery room stay time of patients in group B were significantly shorter than those in group A(P<0.05).The incidence of agitation during the awakening period of patients in group B was significantly lower than that in group A(P<0.05),and the cognitive function score at the time of 2 hours after awakening of patients in group A was significantly lower than that in group B(P<0.05).Conclusion For elderly obese patients undergoing hip joint replacement with intravenous inhalation combined with general anesthesia,sevoflurane can be eluted by decreasing concentration elution method before the end of surgery,and the patient wakes up smoothly and in a shorter time,with fewer adverse reactions and less impact on postoperative cognitive function.
陈铁胜;田振;郝红旗;仲华娟;戴体俊
南京鼓楼医院集团宿迁医院/徐州医科大学附属宿迁医院麻醉科,江苏宿迁 223800徐州医科大学麻醉药理学教研室,江苏 徐州 221004
药学
七氟烷洗脱方法老年患者肥胖苏醒质量认知功能
sevofluraneelution methodelderly patientsobesityawakening qualitycognitive function
《局解手术学杂志》 2024 (012)
1044-1047 / 4
国家自然科学基金(30872432);江苏省宿迁市科技指导计划(Z2019179)
评论