依托咪酯静脉全麻联合ficb对老年全髋关节置换术poc条d的影响.docx

有统计学意义(P(0．05)；术后3d共有15例发生POCD，其中NE组(1例 有统计学意义(P(0．05)；术后3d共有15例发生POCD，其中NE组(1例 3．4％)较NS组(6例22．2％)和E组(8例25．O％)发生率降低，有统计学 意义(尺0．05)；NS组和E组术后1d和术后3dPOCD发生率组间比较无明 显差异(乃O．05)。7．三组患者术后均无术中知晓、穿刺部位感染及穿刺 部位神经损伤的发生，NE组、NS组、E组术后恶心呕吐发生率分别为20．7％ (6例)、14．896(4例)、28．1％(9例)，比较没有统计学意义(P)0．05)。 8．三组患者术中瑞芬太尼用量(E组NE组NS组)比较具有显著差异 (P(0．05)；术后镇痛药追加次数E组较NE组和NS组明显增多(PC0．05)， NE组和NS组比较没有差异(fP0．05)。结论：依托咪酯静脉全麻联合FICB 用于老年全髋关节置换可以减少术后早期POCD的发生率，并降低术后1d、 术后3d的血清S100 B蛋白、NSE浓度的升高程度，有一定的中枢保护作用。 关键词：依托咪酯；七氟醚；血清S100 B蛋白；术后认知功能障碍；髂筋 膜腔隙阻滞； 万方数据 Effect Effect of etomidate intravenous anesthesia combined FICB on POCD in elderly patients undergoing total hip replacement Abstract Objective：To discuss the effect of etomidate intravenous anesthesia combined fascia iliaca compartment block on postoperative cognitive dysfunction in elde． -rly patients undergoing total hip replacement．Methods：Ninety．six elderly patients who are scheduled for unilateral total hip replacement were enrolled and randomly divided into three groups：etomidate intravenous anesthesia combined FICB group(group NE，n=32)，sevoflurane anesthesia combined FICB group(group NS，n=32)，etomidate intravenous anesthesia group(group E， n232)．The vital signs were monitored after patients into the operating room，and inspiring oxygen with mask after premedicated with midazolam 0．03mg／kg． Line on the left side of the radial artery puncture catheter under local anesthesia to monitor blood pressure，and NE group and NS group need to apply FICB． Patients with nerve blook of success and E group were induced with intravenous sufentanil 0．3ug／kg，etomidate 0．2-0．3mg／kg，cisatracurium O．1 5mg ／kg followed by mask insertion and ventilation．All the patients were given a in． 一fusion of remifentanil at 0．08—0．3ug／kg／min．The patients in group NE and group E were given a continuous intravenous infusion of etomidate at 7-1 4ug／- kg／min，while the patients in group NS were given a sevoflurane anesthesia at 2-4％，and regulated the dose of etomidate or sevoflurane accor