| Objective: To evaluate the effect of perioperative application of gauconitine on postoperative delirium in elderly patients with general anesthesia,and to explore its safety and efficacy.Methods: In this randomized controlled study,80 elderly patients undergoing spinal surgery under intravenous aspiration combined anesthesia were selected from the Affiliated Hospital of Shandong University of Chinese Medicine from January 2022 to December 2022.The patients meeting the criteria were randomly divided into two groups,experimental group(group A)and control group(group B),with 40 cases in each group.The age,gender,height and weight of the two groups of patients were statistically analyzed to observe whether the difference was statistically significant.Patients in group A were given 0.06mg/kg intramuscular injection of hyperuronitine for advanced analgesia before anesthesia,patients in group B were not given special treatment,and other treatments were consistent between the two groups.The anesthesia process was completed by the same anesthesiologist,and anesthesia was maintained during the operation according to the specific conditions of the patients,and the drug types were consistent between the two groups.After the operation,patients were given an analgesic pump for self-controlled intravenous analgesia until 48 hours after the operation.The analgesic pump in the observation group was palonosetron 0.25mg+ Sufentanil 2μg/kg+ homonitracine0.3mg/kg,and the analgesic pump in the control group was: Palonosetron0.25mg+ sufentanil 2.5μg/kg,both groups were diluted with 100 ml normal saline,the background dose,automatic supplementary dose and locking time were set to 1ml/h,2ml,15 minutes,respectively.Age,time of operation,time of anesthesia,and vital signs before and after surgery were analyzed in the two groups.The changes of postoperative blood C-reactive protein(CRP)concentration were compared between the two groups.Scores of the Montreal Cognitive Assessment Scale(MOCA scale)were recorded at 24 h and 48 h and 72 h after surgery.VAS scores were recorded at 24 h,48h and 72 h after surgery.Postoperative analgesia was recorded in the two groups,and the incidence of postoperative delirium and adverse reactions were counted.Results: There was no significant difference between the two groups in gender,age,operation and anesthesia time(P > 0.05).The postoperative VAS score of the two groups was compared,and the number of patients in different scoring segments of the two groups was statistically significant(P < 0.05).The VAS score of the experimental group was lower and the analgesic effect was better.The incidence of postoperative remedial analgesia in the experimental group(12.5%)was lower than that in the control group(30%).The MOCA scale score of the two groups was compared,and the score of the experimental group was higher than that of the control group.The number of patients in different scoring segments was counted,and the difference was statistically significant(P < 0.05).After the comparison of postoperative C-reactive protein between the two groups,the experimental group was lower than the control group,the difference was statistically significant(P < 0.05),and the increase trend of the experimental group was stable.The incidence of adverse reactions was compared between the two groups.There was no postoperative laryngeal and airway spasm in the two groups.The incidence of postoperative delirium in the experimental group(5%)was lower than that in the control group(12.5%).Conclusion: Perioperative application of hyperaconitine can reduce postoperative delirium and postoperative pain in elderly patients.At the same time,it can reduce the postoperative C-reactive protein concentration,reduce inflammatory reaction and promote the recovery of patients.It is convenient,fast and low cost for the clinical application of leuconitine,which can be widely used in the elderly patients with postoperative analgesia and intervention of postoperative delirium. |
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