中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (11): 1039–1042.doi: 10.12007/j.issn.0258-4646.2016.11.019

• 论著 • 上一篇    下一篇

右美托咪定对开腹手术中老年患者脑氧饱和度及 术后认知功能的影响

侯大亮,吴秀英   

  1. 中国医科大学附属盛京医院麻醉科,沈阳 110004
  • 收稿日期:2016-04-13 出版日期:2016-11-29 发布日期:2016-11-04
  • 通讯作者: 吴秀英 E-mail:wuxy@sj?hospital.org
  • 作者简介:侯大亮(1989 -),男,医师,硕士 .

Effect of Dexmedetomidine on Postoperative Cognitive Function and Intraoperative Regional Cerebral Oxygen Saturation of Middle-aged and Elderly Patients Undergoing Open Surgery

HOU Daliang,WU Xiuying   

  1. Department of Anesthesiology,Shengjing Hospital,China Medical University,Shenyang 110004,China
  • Received:2016-04-13 Online:2016-11-29 Published:2016-11-04

摘要: 目的 探索右美托咪定是否能通过提高术中脑氧饱和度而改善择期行全麻下开腹手术的中老年患者术后认知功能。 方法 选择行全麻下开腹手术的中老年患者 40 例,随机分为 2 组:D 组(n = 20),术前静注右美托咪定(0.5 μg/kg),浓度 4 μg/ mL,10 min 静脉泵入;N 组(n = 20),术前静注等量的生理盐水。监测 2 组患者的心率、平均动脉压及脑氧饱和度。术前与术后 进行简易智力状态检查(MMSE)。结果 入室时 2 组患者心率无明显差异(P > 0.05),在给药后各时间点,D 组心率显著低于 N 组,差异有统计学意义(P < 0.05)。2 组患者在各时间点的血压及脑氧饱和度无明显差异(P > 0.05)。D 组患者术后第 1 天的 MMSE 评分高于 N 组,差异有统计学意义(P < 0.05)。结论 术前给予右美托咪定可以改善择期行全麻下开腹手术的中老年患 者术后认知功能,但不能影响患者的脑氧饱和度。右美托咪定改善术后认知功能的作用不是通过提高术中脑氧饱和度实现 的。

关键词: 右美托咪定, 中老年患者, 开腹手术, 脑氧饱和度, 术后认知功能

Abstract: Objective To investigate whether dexmedetomidine can improve the postoperative cognitive function of middle-aged and elderly patients undergoing selective open surgery with general anesthesia via elevating intraoperative regional cerebral oxygen saturation. Methods Forty middle-aged and elderly patients that were scheduled for open surgery were recruited in the study and randomly assigned to two groups :patients in group D(n = 20)received dexmedetomidine 0.5 μg/kg iv(concentration 4 μg/mL)injected at 10 minutes before the operation while those in group N(n = 20)were injected with normal saline with the same quantity. Results There was no significant difference of the heart rates of the pa- tients in two groups when they entered the operating room(P > 0.05). The heart rates of the patients in group D decreased significantly compared with those in group N at all-time points after the administration of drugs ( P < 0.05). No significant difference in mean arterial pressure or regional cerebral oxygen saturation was observed at any time point(P > 0.05). The patients in group D had higher MMSE scores than those in group N(P <0.05),with statistical significance. Conclusion Preoperative administration of dexmedetomidine improves postoperative cognitive function of middle-aged and elderly patients undergoing selective open surgery with general anesthesia,which cannot affect the regional cerebral oxygen saturation of the patients. The effect of improving postoperative cognitive function of dexmedetomidine is not achieved by elevating intraoperative regional cerebral oxygen saturation.

Key words: dexmedetomidine, middle-aged and elderly patients, open surgery, regional cerebral oxygen saturation, postoperative cognitive function

中图分类号: 

  • R614.2
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