Effect of Sufentanil pretreatment on the postoperative cognitive function in elderly patients undergoing articulation coxae surgery with combined anesthesia
ZHAO Zhiru;LI Rong;Department of Anesthesiology,the First Hospital of Baotou Medical College;
Objective: To investigate the effects of sufentanil on the postoperative cognitive function dysfunction( POCD) and explore its pathogenesis mechanisms. Methods: 72 cases of elderly patients undergoing articulation coxae surgery with ASA Ⅱ-Ⅲ spinal-epidural combined anesthesia were randomly divided into three groups: low-dose group( group L,n = 21,sufentanil 0. 05 ug·kg),high-dose group( group H,n =22,sufentanil 0. 1 ug·kg) and control group( group C,n = 29,saline 2 mL). IL-1β and TNF-α were measured before and after the operation. MMSE was adopted to estimate the cognitive function on the instant,1 d,3 d and 7 d after the surgeon. Results: Compared with those before the surgery,MMSE scores decreased significantly on the instant,1 d,3 d and 7 d after the surgeon( P ﹤ 0. 05). The incidence rate of POCD on the instant,1 d,3 d and 7 d after the surgeon in group H was lower than that in group C and group L( P ﹤ 0. 05). The levels of IL-1β and TNF-α increased significantly compared with those before the surgery,and the levels of IL-1β and TNF-α in group H were lower than those in group C and L( P ﹤ 0. 05). Conclusion: Sufentanil reduces the incidence rate of POCD. The effect is associated with the dose,and its mechanism may be associated with its inhibition effect on the inflammatory reaction related with IL-1β and TNF-α.
【CateGory Index】： R614