The Influence Of Remy Fentanyl Joint Propofol Controlling Buck To The Cognitive Function Of Old People After Total Hip Arthroplasty

Objective:To compare the relationship of1fentanyl joint c poisson phenol and postoperative blood pressure control cognitive dysfunction (POCD)。 And looking for a safe and reasonable controlling step-down anesthesia method for clinicalMethod:All the cases are from Yanbian University Affiliated Hospital, Elective surgery Do120patients with hip replacement surgery. Age is70-80years-old. ASA Ⅱ-Ⅲ, weigh50-80Kg, Preoperative cognitive function normally, Operation time2-3hours. Exclusion standard:Serious cardiopulmonary liver and kidney function obstacle, obesity, asthma history, the hammersmith watts’s medical history. Will surgery patients were randomly divided into three groups (Ⅰ, Ⅱ, Ⅲ)40cases in each group. Ⅰ group of intraoperative no controlling blood pressure and maintain MAP in the90-100mmHg, Ⅱ group do controlling blood pressure (MAP maintained in60-70mmHg) last time30min-60min, Ⅲ group do controlling blood pressure (MAP maintained in60-70mmHg) duration60-90min. All of the patients need not preoperative medicine. home invasion open after vein circuit.Mi was given to hebron, propofol, fentanyl, the type, ammonium library. Rapid induction tracheal intubation mechanical ventilation. Ventilation modes are pressure control ventilation. Intraoperative TCI pump into the propofol and Rachel fentanyl and timing additional trans-isomer of library, ammonium maintain anesthesia. Intraoperative monitoring mean arterial pressure (MAP) heart rate (HR) pulse oxygen saturation (SpO2) index.. Postoperative recovery room to anesthesia. Simple application intelligent mental state check scale (MMSE) test evaluation of patient preoperative and postoperative (24HR,3d, 7d) the cognitive function of change.Result:Three groups of the patient’s age, sex ratio, weight, the comparison of the operation time there were no statistically significant, p>0.05. Three groups of patients with a mean arterial pressure (MAP) heart rate (HR) blood oxygen saturation (SPO2) is both not significant, p>0.05. Three groups of patients operation time to wake up of time and PACU retention time comparison. Ⅰ groups of patients waking time, PACU residence time in Ⅱ significantly short, Ⅲ group (p<0.01), Ⅱ, Ⅲ group is not statistically significant, between(p>0.05). Three groups of patients POCD incidence of comparison, the first and the third day after POCD rate are statistically significant. Postoperative day11group12.5%,2group15%, three groups of20%. Postoperative day31group5%,2group7.5%, three groups of12.5%.7days after all is5%, and there were no significant differencesConclusion:1intraoperative no controlling step-down1and3days after a lower incidence POCD controlling blood pressure groups, but operation time was significantly longer.2bank for controlling step-down was60-90min can shorten the timing of the operation, but obviously increase the incidence of postoperative POCD.3bank was controlling step-down lasts30-60min can obviously reduce the timing of the operation, but slightly increasing incidence of postoperative POCD,, clinical anesthesia method can be according to the patient POCD preoperative risk assessment for choice.