| 王和节,蒋毅,诸光峰,等.右美托咪定联合胸椎旁神经阻滞麻醉对胸腔镜手术患者术后睡眠与认知功能的影响[J].中国临床保健杂志,2023,26(2):225-229. |
| 右美托咪定联合胸椎旁神经阻滞麻醉对胸腔镜手术患者术后睡眠与认知功能的影响 |
| Effects of dexmedetomidine combined with TPVB anesthesia on postoperative sleep and cognitive function in patients undergoing thoracoscopic surgery |
| 投稿时间：2023-01-07 |
| DOI：10.3969/J.issn.1672-6790.2023.02.019 |
| 中文关键词: 胸腔镜检查 睡眠质量 术后认知并发症 生命体征 右美托咪啶 神经传导阻滞 |
| 英文关键词: Thoracoscopy Sleep quality Postoperative cognitive complications Vital signs Dexmedetomidine Nerve block 〖FL |
| 基金项目:浙江省温州市科技计划经费自筹项目(Y20180566) |
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| 中文摘要: |
| 目的 探讨右美托咪定联合胸椎旁神经阻滞(TPVB)麻醉对胸腔镜手术患者术后睡眠与认知功能的影响。方法 将2019年2月1日至2021年2月28日在温州市中西医结合医院收治的100例胸腔镜手术患者按照随机数字表法分成对照组和观察组。对照组50例应用TPVB麻醉,观察组50例应用右美托咪定联合TPVB麻醉。观察2组的麻醉效果、生命体征、术后疼痛程度、睡眠质量、认知功能以及不良反应。结果 观察组椎旁阻滞起效时间短于对照组,脊神经阻滞节段多于对照组(P＜0.05)；观察组术中平均动脉压与心率优于对照组(P＜0.05)；观察组术后视觉模拟评分法(VAS)评分低于对照组(P＜0.05)；观察组术后1 d的匹兹堡睡眠质量指数(PSQI)评分低于对照组(P＜0.05)；观察组术后1 d的简易智力状态检查量表(MMSE)评分高于对照组(P＜0.05)；2组不良反应发生率相近(P＞0.05)。结论 右美托咪定联合TPVB麻醉在胸腔镜手术中的应用效果较好,可稳定患者术中生命体征,减轻术后疼痛,对患者睡眠质量与认知功能的影响轻微,不良反应少。 |
| 英文摘要: |
| Objective To investigate the effect of dexmedetomidine combined with thoracic paravertebral nerve block (TPVB) anesthesia on postoperative sleep and cognitive function in patients undergoing thoracoscopic surgery.Methods One hundred patients with thoracoscopic surgery admitted in our hospital from February 1,2019 to February 28,2021 were randomly divided into control group and observation group.The 50 patients in the control group were treated with TPVB anesthesia,and 50 patients in the observation group were treated with dexmedetomidine combined with TPVB anesthesia.The anesthetic effect,vital signs,postoperative pain,sleep quality,cognitive function and adverse reactions were observed in the two groups.Results The onset time of paravertebral block in the observation group was shorter than that in the control group,and the spinal nerve block segments were more than those in the control group (P<0.05).The mean arterial pressure and heart rate in the observation group were better than those in the control group (P<0.05).The visual analog scale (VAS) score of the observation group was lower than that of the control group (P<0.05).The pittsburgh sleep quality index (PSQI) score of the observation group 1 day after operation was lower than that of the control group (P<0.05).The mini-mental State Examination (MMSE) score of the observation group 1 day after operation was higher than that of the control group (P<0.05).The incidence of adverse reactions in the two groups was similar (P>0.05).Conclusions Dexmedetomidine combined with TPVB anesthesia has a good effect in thoracoscopic surgery.It can stabilize the vital signs of patients during operation and reduce postoperative pain.It has a slight impact on the sleep quality and cognitive function of patients,and has few adverse reactions. |
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