| 刘琳 霍星 牛芳芳 刘天琳 石荷洁.利多卡因对老年胃癌根治术患者术后认知功能障碍的影响[J].,2016,16(30):5858-5860 |
| 利多卡因对老年胃癌根治术患者术后认知功能障碍的影响 |
| Effect of Lidocaine on the Postoperative Cognitive Dysfunction in ElderlyPatients Undergoing Radical Surgery for Gastric Cancer |
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| DOI： |
| 中文关键词: 利多卡因 术后认知功能障碍 老年 胃癌 |
| 英文关键词: Lidocaine Elderly Gastric cancer radical Postoperative cognitive dysfunction |
| 基金项目:黑龙江省自然科学基金项目（D201071） |
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| 中文摘要: |
| 目的：观察利多卡因对老年胃癌患者术后认知功能障碍的预防作用。方法：选择择期胃癌手术患者80 例，ASA 分级Ⅱ或Ⅲ
级，性别不限，年龄大于等于60 岁，BMI20-25 kg/m2,随机分为2 组(利多组和对照组)：利多组40 例，麻醉诱导前静脉给予利多卡
因1.0 mg/kg，然后以1.5 mg/kg/h 速率静脉输注至术毕前30 min；对照组40 例，给予同等剂量和同等用法的生理盐水。术中维持
BIS值在40-60。术后两组均行经静脉患者自控镇痛(patient controlled intravenous analgesia，PCIA)，PCIA 镇痛泵配法：两组均为芬
太尼20 ug/kg+ 生理盐水总量300 mL。观察并记录入室时刻(T0)、气管插管即刻(T1)、手术开皮即刻(T2)、开皮后半小时(T3)以及出
手术室时刻(T4)的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO2)。记录术前1 d及术后6 h、1 d、2 d、3 d、7 d简易智能量表
(mini-mental state examination，MMSE)评分并进行比较，术后评估并记录术后6 h、1 d、2 d、3 d及7 d静息和活动时视觉模拟评分
(visual analogue scales，VAS)评分。结果：①与对照组比较，利多组术后6 h、1 d、2 d和3 d静息和活动时VAS 疼痛评分均明显降
低，差异有统计学意义(P<0.05)；②利多组4 例发生认知功能障碍(10.0%)，对照组13 例发生认知功能障碍(32.5%)，利多组认知功
能障碍的发生率和持续时间较对照组明显降低(P<0.05)，差异均有统计学意义(P<0.05)。结论：围术期静脉输注利多卡因可以预防
老年胃癌根治术患者术后认知功能障碍，有利于减轻术后疼痛。 |
| 英文摘要: |
| Objective:To observe the preventive effect of lidocaine on cognitive dysfunction in elderly patients.Methods:Eighty
cases of patients undergoing gastric cancer radical surgery (ASA II or III, all genders, age 60 or older, BMI: 20-25 kg/m2)were randomly
divided into two groups: lidocaine group and control group. They were treated with either lidocaine (lidocaine group,40cases) or saline
(control group, 40 cases). The lidocaine group was given 1.0 mg/kg loading dose of lidocaine within 5 min before endotracheal
intubation, while 1.5 mg/kg/h was pumped with micropump until 30 min before the end of surgery. The control group was offered the
same amount of saline. All the patients of both groups received patient-controlled intravenous analgesia (PCIA). Both groups were given
fentanyl 20 ug/kg and the same amount of saline. The indexes of MAP, HR, SpO2 were recorded at the time patients coming into the
operating room(T0), at the time of endotracheal intubation (T1), the beginning of surgery (T2), 30 min after the beginning of surgery(T3),
the time leaving the operating room(T4). The value of mini-mental state examination (MMSE) at 1 d before surgery and 6 h, 1 d, 2 d, 3 d,
7 d after surgery was recorded, and the valuee of active visual analogue scores(VAS) was evaluated at 6 h, 1 d, 2 d, 3 d, 7 d after surgery.Results:VAS scores in observation group after surgery 6 h, 1 d, 2 d and 3 d were lower than those in control group (P<0.05). Incidence
rate of postoperative cognitive dysfunction was significantly lower in observation group (4, 10.0%) than that in control group (13, 32.5%)
(P<0.05).Conclusion:Lidocaine could reduce the incidence of postoperative cognitive dysfunction in the eldly patients undergoing
gastric cancer radical surgery with the vital signs more stable, lidocaine could effectively assist the postoperative analgesic efficacy. |
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