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右美托咪定对老年腹腔镜手术患者围手术期血流动力学及早期认知功能的影响

Effect of dexmedetomidine on perioperative haemodynamics and early cognitive function in elderly patients undergoing laparoscopic surgery.

作者信息

Li Qiong, Fu Li-Ying, Zhao Yue-Hong, Shi Wei-Gang, Sun Wen, Zhang Xiao-Nan, Cheng Lin-Shu, Ma Xi-Qian

机构信息

Department of Anaesthesiology, Shijiazhuang Sixth Hospital, Shijiazhuang, Hebei, China.

Department of Obstetrics, Ningjin County Maternal and Child Health Hospital, Xingtai, Hebei, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2023 Sep;18(3):533-540. doi: 10.5114/wiitm.2023.130329. Epub 2023 Aug 4.

Abstract

INTRODUCTION

Laparoscopic minimally invasive surgery has been widely used in the diagnosis and treatment of gynaecological diseases.

AIM

To investigate the effect of dexmedetomidine on perioperative haemodynamics and cognitive function in elderly gynaecological patients who underwent laparoscopic surgery.

MATERIAL AND METHODS

Clinical baseline characteristics, haemodynamic parameters, renin activity, norepinephrine level, cognitive function, pain level, and sedation were compared between the 2 groups.

RESULTS

At T4 (10 min after extubation) and T5 (1 h after extubation), significant differences were found in systolic blood pressure, diastolic blood pressure, and heart rate between the 2 groups (p < 0.05); renin activity and norepinephrine level were much lower in the dexmedetomidine group than in the control group at T3 (10 min before extubation) and T4 (p < 0.05). One day before surgery, there were no significant differences in Mini-mental state examination (MMSE), visual analogue scale (VAS), and Ramsay scores between the 2 groups (p > 0.05), but the MMSE score 1 day after surgery and the Ramsay score at 12 h after surgery in the dexmedetomidine group were much higher than that in the control group (p < 0.05). Notably, at 2, 4, 12, 24, and 48 h after surgery, the VAS score in the dexmedetomidine group was significantly lower than that in the control group (p < 0.05).

CONCLUSIONS

Dexmedetomidine has a better clinical effect in improving perioperative haemodynamics and early cognitive function in elderly gynaecological patients who received laparoscopic surgery.

摘要

引言

腹腔镜微创手术已广泛应用于妇科疾病的诊断和治疗。

目的

探讨右美托咪定对老年妇科腹腔镜手术患者围手术期血流动力学及认知功能的影响。

材料与方法

比较两组患者的临床基线特征、血流动力学参数、肾素活性、去甲肾上腺素水平、认知功能、疼痛程度及镇静情况。

结果

在T4(拔管后10分钟)和T5(拔管后1小时)时,两组患者的收缩压、舒张压及心率存在显著差异(p<0.05);在T3(拔管前10分钟)和T4时,右美托咪定组的肾素活性和去甲肾上腺素水平显著低于对照组(p<0.05)。手术前一天,两组患者的简易精神状态检查表(MMSE)、视觉模拟评分法(VAS)及 Ramsay评分无显著差异(p>0.05),但右美托咪定组术后1天的MMSE评分及术后12小时的Ramsay评分显著高于对照组(p<0.05)。值得注意的是,术后2、4、12、24及48小时,右美托咪定组的VAS评分显著低于对照组(p<0.05)。

结论

右美托咪定对接受腹腔镜手术的老年妇科患者围手术期血流动力学及早期认知功能的改善具有较好的临床效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26ad/10585469/be386b1da2bd/WIITM-18-51203-g001.jpg

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