摘要
Abstract
Objective To observe the anesthetic efficacy and safety of ciprofol injection and propofol injection in postoperative analgesia of elderly patients undergoing total knee arthroplasty.Methods According to cohort method,patients undergoing total knee arthroplasty were divided into control group and treatment group.The control group was given intravenous injection of 2.0 mg·kg-1 propofol injection during anesthesia induction and intraoperative infusion of 4.0-12.0 mg·kg-1·h-1 propofol injection,while treatment group was given intravenous injection of 0.3 mg·kg-1 ciprofol injection during anesthesia induction and intraoperative infusion of 0.4-2.4 mg·kg-1·h-1 ciprofol injection.The anesthesia-related indexes[induction time,recovery time in post-anesthesia care unit(PACU),awaking time],postoperative pain[visual analogue scale(VAS)],hemodynamic indexes[heart rate(HR),mean arterial pressure(MAP)]and stress response[cortisol(Cor),norepinephrine(NE)]in the two groups were compared,and safety evaluation was performed.Results There were 38 patients in treatment group and 37 patients in control group,respectively.The induction time of treatment group and control group were(73.32±13.19)and(52.96±10.54)s,and the difference was statistically significant(P＜0.05).The recovery time of PACU and postoperative awaking time in treatment group and control group were[(40.35±6.47),(41.88±6.75)min]and[(7.82±1.47),(7.51±1.35)min],the difference was not statistically significant(all P＞0.05).At 24 h after surgery,VAS scores in treatment group and control group were(2.20±0.22)and(2.33±0.28)points,the difference was statistically significant(P＜0.05).Immediately after surgery,HR and MAP in treatment group and control group were[(73.55±8.12),(79.14±8.83)beat·min-1]and[(80.47±7.89),(86.70±8.13)mmHg],the differences were statistically significant(all P＜0.05).At 1 d after surgery,levels of serum Cor and NE in treatment group and control group were[(605.99±82.46),(661.32±89.40)nmol·L-1]and[(3.14±0.69),(3.75±0.73)nmol·L-1],the differences were statistically significant(all P＜0.05).The main adverse drug reactions in treatment group were hypotension,postoperative delirium,nausea and vomiting,while those in control group were hypotension,postoperative delirium,nausea and vomiting,bradycardia and respiratory depression.The difference in total incidence of adverse drug reactions between treatment group and control group was statistically significant(18.42％vs 59.46％,P＜0.05).Conclusion Compared with propofol injection,ciprofol injection can improve anesthetic effect,alleviate postoperative pain,reduce stress response and incidence of adverse drug reactions in elderly patients after total knee arthroplasty,which has few effects on hemodynamics.关键词
环泊酚注射液/丙泊酚注射液/老年患者/膝关节置换术/镇痛/应激反应/预后Key words
ciprofol injection/propofol injection/elderly patient/total knee arthroplasty/analgesia/stress response/prognosis分类
医药卫生
