右美托咪定复合地佐辛静脉自控镇痛对高龄骨科患者术后睡眠和认知的影响

doi:10.3969/j.issn.2095-378X.2021.01.015

Abstract

Abstract: Objective To investigate the effect of dexmedetomidine （Dex） combined with dezocine in patient-controlled intravenous analgesia （PCIA） on the quality of sleep and the early cognitive function of elderly patients with spinal anesthesia after operation. Methods Sixty-five elderly patients aged 80-96 years undergoing spinal anesthesia from the department of orthopedics were randomly divided into two groups by random table method： dezocine group （group C, n=32） and dezocine plus Dex group （group D, n=33）. Pittsburgh sleep quality index （PSQI） was assessed at preoperation, 24 h and 48 h postoperation, and before discharge, respectively. Visual Analogue Scale （VAS） score and Ramsay score were observed 4, 8, 12, 24, and 48 h after surgery, respectively. Mini-Mental Status Examination （MMSE） score was recorded at 1d before surgery and 1, 3, 7 d after surgery, respectively, and the incidence rate of postoperative cognitive dysfunction was evaluated as well. The postoperative incidence rates of nausea, vomiting, somnolence, and urinary catheter discomfort were also evaluated. Results The PSQIs in the group D at postoperative 24 h and 48 h and before discharge were significantly lower than those in the group C （P<0.05）. The postoperative Ramsay score in the group D was significantly higher than that in the group C （P<0.05）. The postoperative MMSE scores in the group D were also significantly higher （P<0.05）, and the incidence rate of POPD was lower （P<0.05）. The group D showed a lower VAS score, and less nausea, vomiting, urinary catheter discomfort incidence rates （P<0.05）. Conclusion Dex combined with dezocine in PCIA help improve the quality of sleep and reduce postoperative cognitive dysfunction in elderly patients.

Key words: Dexmedetomidine, Elderly, Patient-controlled intravenous analgesia, Sleep quality, Cognition, Spinal anesthesia

CLC Number:

R614.4

LU Feifei, FENG Xiumei, CAO Yong, LI Yanmin, CHENG Wei. Effect of dexmedetomidine and dezocine in patient-controlled intravenous analgesia on postoperative sleep quality and cognition of elderly patients[J]. Surgical Research and New Technique, 2021, 10(1): 52-56.

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Effect of dexmedetomidine and dezocine in patient-controlled intravenous analgesia on postoperative sleep quality and cognition of elderly patients

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