Objective To investigate the clinical effects of analgesics,mainly weak opioids and classical opioids,on postoperative cognitive function in elderly patients with limb fracture.Methods Seventy elderly patients with fractures of femur tibia and humerus admitted to our hospital from May 2021 to May 2024 were prospectively selected and divided into opioid group and weak opioid group with 35 cases in each by drawing lots.Patients in the opioid group received general anesthesia with Sufentanil as an opioid,and patients in the weak opioid group received general anesthesia with esketamine as a weak opioid.The anesthetic effect,the changes of mean arterial pressure,heart rate,blood oxygen saturation,cognitive function and the incidence of adverse reactions were compared.Results There was no significant difference in the rate of good anesthesia between the two groups(P＞0.05).The mean arterial pressure at 5 min after anesthesia(T2)and skin incision(T3)[(93.8±10.3)mmHg,(93.3±13.0)mmHg]and blood oxygen saturation[(98.8±1.7)％,(99.0±1.6)％]in weak opioid group were higher than those in opioid group.T3 heart rate(85.2±11.5)times/min was lower than that of opioid group(P＜0.05);Lowenstein occupational therapy cognitive scale(24 h after recovery from anesthesia and 24 h after surgery)LOTCA scores(44.6±4.7)and(46.0±3.6)were higher than those in opioid group(P＜0.05).The incidence of adverse reactions in weak opioid group was lower than that in opioid group(P＜0.05).Conclusion There is no significant difference in the excellent and good rates of general anesthesia between weak opioids and opioids for elderly patients with fractures of femur tibia and humerus.However,the use of weak opioids can stabilize intraoperative hemodynamic indexes and reduce the impact on postoperative cognitive function,with high safety.
维普
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