关键词:  , 腹部手术；右美托咪定；瑞芬太尼；麻醉效果；术后认知功能障碍

Abstract:

Objective： To investigate the anesthetic effect of dexmedetomidine （Dex） combined with remifentanil in elderly patients undergoing abdominal surgery and its effect on postoperative cognitive dysfunction （POCD）.Methods： A total of 120 elderly patients underwent abdominal operation in our hospital from September 2019 to September 2022 were selected and divided into the group A （n=60） and the group B （n=60） by random number table method. Remifentanil was used as anesthesia in the group B and Dex combined with remifentanil was used as anesthesia in the group A. The indexes of hemodynamics， cognitive function， stress response and recovery quality of the two groups of patiens were compared.Results： The hemodynamic indexes of patients in the group A were higher than those in the group B during in tubation （P<0.05）. The scores of mini-mental state examination （MMSE） of patients in the group A were higher than those in the group B at 1， 3 and 7 d after surgery （P<0.05）， and the incidence of POCD in the group A was lower than that in the group B at 1 d after surgery （P<0.05）. The level of malondialdehyde （MDA） of patients in the group A was lower than that in the group B at 1 d after surgery， while the levels of superoxide dismutase （SOD） and total antioxidant capacity （T-AOC） of patients in the group A were higher than those in the group B （P<0.05）. The recovery time of spontaneous respiration， eye opening time， extubation time and orientation recovery time of patients in the group A were earlier than those in the group B （P < 0.05）.Conclusion： Dex combined with remifentanil has good anesthetic effect in elderly patients undergoing abdominal surgery， which can reduce the risk of POCD， reduce stress response and improve the quality of recovery.

Key words: Abdominal surgery； , Dexmedetomidine； , Remifentanil； , Anesthetic effect； , Postoperative cognitive dysfunction