Effect of Subanesthetic Dose of Esketamine Combined with TAPB on Neurocognitive Function in Elderly Patients Undergoing Abdominal Surgery
Objective To observe the clinical effect of subanesthetic dose of esketamine combined with transversus abdominis plane block(TAPB)on improving neurocognitive function in elderly patients undergoing abdominal surgery.Methods The elderly patients who underwent elective abdominal surgery in Chaohu Hospital Affiliated to Anhui Medical University from January to May 2023 were selected as the research objects.According to the random number table method,they were divided into group S and group C,with 46 patients in each group.In group S,0.25 mg/kg esketamine was injected intravenously before induction,while in group C,the same amount of normal saline was injected intravenously.After that,TAPB was performed in both groups,and anesthesia induction was performed after the anesthesia plane was stable.During the operation,group S was maintained with 0.25 mg/(kg·h)esketamine,and group C was maintained with 0.25 mg/(kg·h)normal saline.The MMSE score,incidence of PND,incidence of POD,vital signs,incidence of adverse reactions,VAS score,Ramsay sedation score,intraoperative opioid dosage and incidence of body movement reaction during TAP were compared between the two groups.Results The MMSE scores at D1 and D3 in group S were higher than those in group C,the incidence of PND was lower than that in group C(P＜0.05),and the incidence of POD at DI in group S was lower than that in group C(P＜0.05).MAP at T1 and T2 in group S was higher than that in group C,HR at T1 was higher than that in group C,and BIS at T1 and T2 was higher than that in group C(P＜0.05),but there was no significant difference in Sp02 between the two groups at each time point(P＞0.05).There was no significant difference in the incidence of nausea and vomiting,irritability and respiratory depression between the two groups within 72 h after operation(P＞0.05).The VAS score of group S was lower than that of group C at 6 h after operation(P＜0.05),but there was no significant difference in Ramsay sedation score between the two groups at each time point after operation(P＞0.05).The dosage of remifentanil in group S was less than that in group C,and the incidence of body movement reaction during TAPB was lower than that in group C(P＜0.05),but there was no significant difference in the dosage of sufentanil between the two groups(P＞0.05).Conclusion In elderly patients undergoing abdominal surgery,subanesthetic doses of esketamine combined with TAPB can improve early neurocognitive function,maintain stable intraoperative vital signs,and reduce early postoperative pain.
EsketamineTransversus abdominis plane blockPerioperative neurocognitive disordersPostoperative deliriumAbdominal surgery in elderly patients
万方数据
维普
