Effects of dexmedetomidine combined with sevoflurane on recovery quality and cognitive function in elderly patients after total knee arthroplasty
Objective To study the effects of dexmedetomidine combined with sevoflurane on recovery quality and cognitive function in elderly patients after total knee arthroplasty(TKA).Methods A total of 120 elderly TKA patients admitted to Weibei Central Hospital from September 2021 to March 2024 were selected for a prospective study,and were divided into an observation group and a control group with 60 cases in each group according to the random number table method.In the observation group,there were 37 males and 23 females,aged(68.79±6.37)years,16 cases of grade Ⅰ and 44 cases of grade Ⅱ classified by the American Society of Anesthesiologists(ASA).In the control group,there were 39 males and 21 females,aged(68.44±7.41)years,17 cases of ASA grade Ⅰ and 43 cases of ASA grade Ⅱ.In the control group,anesthesia was maintained by continuous inhalation of sevoflurane with 1％-2％concentration,and the concentration of sevoflurane was reasonably adjusted according to the patients'bispectral index until 0.5 h before the end of the operation.The observation group was supplemented with dexmedetomidine at 0.5 μg/kg per hour until 0.5 h before the end of the operation.The perioperative conditions,the incidence of agitation during the recovery period,and the change of the Montreal Cognitive Assessment Scale(MoCA)score before and after surgery were compared between the two groups,as well as the adverse reactions.t test and x2 test were used for statistical analysis.Results The awakening time,spontaneous respiration recovery time,and extubation time in the observation group were(8.95±1.30)min,(10.05±1.27)min,and(12.22±1.67)min,which were shorter than those in the control group[(10.21±1.18)min,(13.16±1.40)min,and(16.95±1.74)min],with statistically significant differences(all P＜0.05).The incidence of agitation during the recovery period in the observation group was 5.00％(3/60),which was lower than that in the control group[16.67％(10/60)],with a statistically significant difference(P＜0.05).The MoCA scores in the observation group 6 h and 12 h after surgery were(24.61±1.83)and(26.79±1.40)points,which were higher than those in the control group[(23.45±1.57)and(25.68±1.31)points],with statistically significant differences(both P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion Dexmedetomidine combined with sevoflurane can improve the recovery quality and reduce cognitive impairment in elderly patients after TKA,which is worthy of clinical promotion.
Total knee arthroplastyOld ageDexmedetomidineSevofluraneAwakening qualityCognitive function
万方数据
维普
