右美托咪定对老年患者经尿道前列腺电切术后早期认知功能的影响

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (12): 1389-1392.

右美托咪定对老年患者经尿道前列腺电切术后早期认知功能的影响

靳红绪, 张同军, 孙学飞, 魏兰双, 王立红, 王忠义

河北医科大学附属哈励逊国际和平医院麻醉科,衡水 053000,河北

收稿日期:2013-12-27 修回日期:2014-05-17 发布日期:2020-07-20
作者简介:靳红绪,男,本科,主治医师,研究方向:临床麻醉与镇痛。Tel:13653187769 E-mail:jinhongxu998@163.com

Effects of dexmedetomidine on early postoperative cognitive function after transurethral resection of the prostate in elderly patients

JIN Hong-xu, ZHANG Tong-jun, SUN Xue-fei, WEI Lan-shuang, WANG Li-hong, WANG Zhong-yi

Deparment of Anesthesiology, HARRISON International Peace Hospital, Hebei Medical University, Hengshui 053000, Hebei, China

Received:2013-12-27 Revised:2014-05-17 Published:2020-07-20

摘要/Abstract

摘要： 目的: 探讨右美托咪定(Dex)对老年患者经尿道前列腺电切术(TURP)早期认知功能的影响。方法: 择期拟行TURP患者76例,美国麻醉师协会(ASA)分级I或II级,年龄65~81岁,术前简易智力状态检查量表(MMSE)评分＞23分,采用随机数字表法,将其随机分为2组:Dex组(D组)和生理盐水组(C组),每组38例。全麻诱导前D组静脉输注负荷量Dex 1 μg/kg,10 min 后改为恒速静脉输注Dex 0.5 μg·kg^-1·h^-1至术毕前 30 min, C组采用同样方法静脉输注等容量生理盐水。记录气管插管前(T₀)、气管插管即刻(T₁)、手术开始时(T₂)、手术开始 30 min(T₃)时的MAP和HR以及手术时间、苏醒时间,并分别于术前 24 h、术后 24 h 采用MMSE评分进行神经心理学评估。结果: 两组患者一般资料和术中情况比较差异无统计学意义。C组患者在T₁、T₂时的MAP明显高于D组(P＜0.05)。与C组比较,D组术后 24 h 的MMSE评分明显升高,术后认知功能障碍(POCD)的发生率明显降低(P＜0.05)。结论: Dex可减少老年患者TURP术后早期POCD的发生率,术中麻醉平稳且不影响患者的苏醒。

关键词: 右美托咪定, 术后认知功能障碍, 老年, 经尿道前列腺电切术

Abstract: AIM: To investigate the effect of dexmedetomidine on early postoperative cognitive dysfunction(POCD)in elderly patients who underwent transurethral resection of the prostate (TURP). METHODS: Seventy-six ASA grade I or II patients and mimi mental state exam (MMSE) score＞23, aged 65-81 y, scheduled for elective for TURP were enrolled and randomly divided into 2 groups (n=38 each): Dex group (group D) and control group (group C). Dex 1 μg/kg was infused intravenously over 10 min before anesthesia induction, and then infused at a rate of 0.5 μg·kg^-1·h^-1 until 30 min before the end of the operation in group D. Group C received the equal volume of normal saline with same way. MAP and HR were recorded before intubation (T₀), intubation (T₁), beginning of the surgery (T₂) and 30 min after surgery (T₃). The time of operation and awakening were recorded. Cognitive function was assessed at 24 h before and after operation using MMSE. RESULTS: There were no significant differences of general information and parameters in operation was not statistically significant between the two groups (P>0.05). Compared with group D, MAP at T₁,T₂ in group C were significantly increased (P<0.05). MMSE scores at 24 h after operation were higher in group D and the incidence of POCD was lower than group C (P<0.05). CONCLUSION: Dex can decrease the incidence of early POCD in elderly patients undergoing TURP, hemodynamic parameters is steady and does not affect awakening of patients.

Key words: dexmedetomidine, postoperative cognitive dysfunction, geriatrics, transurethral resection of the prostate

中图分类号:

R614

靳红绪, 张同军, 孙学飞, 魏兰双, 王立红, 王忠义. 右美托咪定对老年患者经尿道前列腺电切术后早期认知功能的影响[J]. 中国临床药理学与治疗学, 2014, 19(12): 1389-1392.

JIN Hong-xu, ZHANG Tong-jun, SUN Xue-fei, WEI Lan-shuang, WANG Li-hong, WANG Zhong-yi. Effects of dexmedetomidine on early postoperative cognitive function after transurethral resection of the prostate in elderly patients[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(12): 1389-1392.

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