摘要
目的探讨椎管内麻醉和全身麻醉对老年骨科患者术后认知功能的影响。方法选取2017年1月-2018年6月在医院行老年骨科手术的患者76例,随机分为椎管内麻醉组(38例)和全身麻醉组(38例),全身麻醉组给予舒芬太尼、丙泊酚、阿曲库铵、咪达唑仑进行麻醉,椎管内麻醉组给予盐酸布比卡因、利多卡因及舒芬太尼进行麻醉,比较两组患者手术时间、苏醒时间、语言表达时间及术前、术后6 h及24 h的简易精神状态检查量表(Mini mental state examination,MMSE)评分。结果与全身麻醉组相比,椎管内麻醉组患者的手术时间、苏醒时间及语言表达时间均显著缩短,差异具有统计学意义(P <0. 05);术前,两组患者的MMSE评分相比,差异无统计学意义(P>0. 05);与术后6 h及24 h全身麻醉组相比,椎管内麻醉组患者术后6 h及24 h的MMSE评分均显著升高,差异具有统计学意义(P <0. 05)。结论相比于全身麻醉,椎管内麻醉对老年骨科患者的麻醉效果较好,可显著提高患者的术后认知功能。
Objective To investigate the effect of intravertebral anesthesia and general anesthesia on cognitive function of elderly patients after orthopedic operations. Methods A total of 76 patients undergoing elderly orthopedic surgery from January 2017 to June 2018 in our hospital were randomly divided into intravertebral anesthesia group( n = 38) and general anesthesia group( n = 38),the former given sufentanil hydrochloride,propofol,atracuriumand midazolam,and the latter given bupivacaine hydrochloride,lidocaine hydrochloride and sufentanil hydrochloride. The two groups were compared in terms of the operation time,eye-opening time and speech time,and the mini mental state examination score before operation and 6 h and 24 h after operation. Results Compared with the general anesthesia group,the operation time,eye-opening time and speech time of the intravertebral anesthesia group were both significantly shortened( P < 0. 05). Before operation,the difference between the groups was not statistically significant( P > 0. 05). Compared with the general anesthesia group 6 h and 24 h after operation,the MMSE score of the intravertebral anesthesia group 6 h and 24 h after operation were both significantly increased( P < 0. 05). Conclusion Compared with general anesthesia,the intravertebral anesthesia has good anesthetic effect in elderly patients with orthopedics,and it can significantly improve the cognitive function after operation.
作者
蔡宜良
陈家趁
周辉
关小园
CAI Yiliang;CHEN Jiachen;ZHOU Hui;GUAN Xiaoyuan(Yangdong District People’s Hospital,Yangjiang 529931,Chin)
出处
《现代医院》
2020年第2期283-285,288,共4页
Modern Hospitals
关键词
骨科
椎管内麻醉
全身麻醉
老年
认知功能
Orthopedics department
Intravertebralanesthesia
General anesthesia
Senium
Cognitive function
