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首页> 外文期刊>Journal of clinical anesthesia >Effect of parecoxib sodium pretreatment combined with dexmedetomidine on early postoperative cognitive dysfunction in elderly patients after shoulder arthroscopy: A randomized double blinded controlled trial
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Effect of parecoxib sodium pretreatment combined with dexmedetomidine on early postoperative cognitive dysfunction in elderly patients after shoulder arthroscopy: A randomized double blinded controlled trial

机译：Parecoxib钠预处理与Dexmedetomidine联合乳腺癌术后认知功能障碍的影响肩部关节镜后术后认知功能障碍：随机双盲对照试验

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摘要

Abstract Study objective To evaluate effect of parecoxib sodium pretreatment combined with dexmedetomidine on early postoperative cognitive dysfunction in elderly patients after shoulder arthroscopy. Design Randomized, double-blind study. Setting University-affiliated teaching hospital. Patients One hundred and fifty-two elderly patients scheduled for shoulder arthroscopy. Interventions At 15 min before the induction of anesthesia, 152 patients received intravenously parecoxib sodium 40 mg and dexmedetomidine at a dose of 0.5 μg/kg over 15 min, followed by a continuous infusion at a rate of 0.5 μg/kg/h until the end of surgery. Then all patients who received postoperative patient-controlled intravenous analgesia were divided 2 groups: sufentanil(0.04μg/kg/h, S group), sufentanil (0.04μg/kg/h) plus dexmedetomidine(0.06μg/kg/h) (SD group). Measurements The mini–mental status examination score in SD group was significantly higher than S group at 1, 2 and 7 days after surgery. The incidence of postoperative cognitive dysfunction during 7 days after surgery in S and SD groups was respectively 17.1% and 6.7%. Compared with the S group, the visual analogue scale scores at rest and upon movement were significantly lower at 6, 14, 24, 36 and 48 h after surgery in SD group; analgesia pump liquid amount during 24 h after surgery and number of rescue analgesia during 48 h after surgery were significantly lower in SD group. Jugular venous oxygen partial pressure and jugular venous oxygen saturation values in SD group were significantly higher than S group at postoperative 24 h. The occurrence of nausea and vomiting within 48 h after surgery in SD group were significantly lower than S group. We found no complications including respiratory depression and sinus bradycardia within 48 h after surgery in all patients. Conclusions Parecoxib sodium pretreatment combined with dexmedetomidine could reduce the incidence of early postoperative cognitive dysfunction in elderly patients. This might be related to the improvement of postoperative analgesia effect and cerebral oxygen metabolism in patients. Highlights ? To explore synergistic effect of Parecoxib sodium and dexmedetomidine combined application. ? Parecoxib sodium pretreatment combined with perioperative dexmedetomidine administration can decrease the incidence of POCD. ? Parecoxib sodium pretreatment combined with using dexmedetomidine in perioperation can provide good analgesia. ? Parecoxib sodium pretreatment combined with using dexmedetomidine in perioperation can improve postoperative SjvO 2 and PjvO 2 .
机译：摘要研究目的是评价帕氏氧化钠预处理与右染素疗效与右侧术后认知功能障碍的疗效评价。设计随机，双盲研究。培养大学附属教学医院。患者百年和五十二名老年患者安排肩部关节镜检查。在诱导麻醉前15分钟的干预率，152名患者在15分钟内以0.5μg/ kg的剂量静脉内吡克西钠40mg和Dexmedetomidine接受，然后以0.5μg/ kg / h的速率连续输注直到末端手术。然后，所有接受术后患者控制的静脉内镇痛的患者分为2组：Sufentanil（0.04μg/ kg / h，s组），sufentanil（0.04μg/ kg / h）加右甲基medetomidine（0.06μg/ kg / h）（sd团体）。测量SD组的迷你精神状态检查评分在手术后1,2和7天的S组显着高于S组。在S和SD组手术后7天内术后认知功能障碍的发生率分别为17.1％和6.7％。与S组相比，SD组手术后休息和运动静止和运动时的视觉模拟规模分数显着降低;镇痛泵液体量在24小时后进行手术和48小时后救援镇痛的数量在SD组中显着降低。 SD组的颈静脉氧分压和颈静脉氧饱和度值显着高于术后24小时的S组。 SD组手术后48小时内的恶心和呕吐的发生显着低于S组。在所有患者手术后48小时内发现任何并发症包括呼吸抑郁症和窦性心动过缓。结论Parecoxib钠预处理结合Dexmedetomidine可以降低老年患者术后认知功能障碍的发病率。这可能与术后镇痛效应和脑氧代谢的改善有关。强调 ？探讨Parecoxib钠和Dexmedetomidine合并应用的协同作用。还Parecoxib钠预处理结合围手术期Dexmedetomidine给药可以降低POCD的发生率。还Parecoxib钠预处理结合使用Dexmedetomidine在透镜中可以提供良好的镇痛。还Parecoxib钠预处理结合使用Dexmedetomidine在围手术期可以改善术后SJVO 2和PJVO 2。

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  • 来源
    《Journal of clinical anesthesia》 |2017年第2017期|共5页
  • 作者

    Jian Lu; Gang Chen; Hongmei Zhou; Qinghe Zhou; Zhipeng Zhu; Cheng Wu;

  • 作者单位

    Department of Anesthesiology Jiaxing Second Hospital Second Affiliated Hospital Jiaxing Medical;

    Department of Orthopaedics Jiaxing Second Hospital Second Affiliated Hospital Jiaxing Medical;

    Department of Anesthesiology Jiaxing Second Hospital Second Affiliated Hospital Jiaxing Medical;

    Department of Anesthesiology Jiaxing Second Hospital Second Affiliated Hospital Jiaxing Medical;

    Department of Anesthesiology Jiaxing Second Hospital Second Affiliated Hospital Jiaxing Medical;

    Department of Anesthesiology Jiaxing Second Hospital Second Affiliated Hospital Jiaxing Medical;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 麻醉学;
  • 关键词

    Cyclooxygenase-2 inhibitor; Dexmedetomidine; Postoperative cognitive dysfunction; Brain; Pain; Elderly;

    机译：环氧氧基酶-2抑制剂;德Xmedetomidine;术后认知功能障碍;脑;疼痛;老人;

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