Effects Of Different Drugson Elderly Patients’ Postoperative Analgesia And Influences On Their Cognitive Competence

PurposeThrough the comparison between Sufentanil and joint Sufentanil flurbiprofen ester, which are used respectively for the analgesic effect of postoperative analgesia and the influence of postoperative cognitive dysfunction on the elderly patients, this thesis aims at exploring a safe and effective analgesic method for the elderly patients.Methods:ASA level Ⅰ～ Ⅲ, eliminate nervous system disease, psychiatric history,65～ 82 years old, operation time (117.9+53.63) min, anesthesia method for general anesthesia, operation types for general surgery (excluding the belly cavity mirror surgery) patients with abdominal surgery in 120 cases.Randomly divided into two groups (n= 60):sufentanil group (group Ⅰ), sufentanil -flurbiprofen ester group (group Ⅱ).Patients with postoperative awake uproot the endotracheal tube (or laryngeal mask),1 hours after the PCIA analgesia pump.Analgesia pump controlled analgesia, background dose:4 ml/h, press the dosage:3 ml, locking time:15 min. Sufentanil group (Ⅰ) in analgesia pump for sufentanil 2.5 μg/kg+0.9% saline 200 ml;Flurbiprofen ester-sufentanil group (group Ⅱ) in analgesia pump for flurbiprofen ester 25 mg/kg+sufentanil 1 μg/kg+0.9% saline 200 ml.One day before surgery (TO), after 6 hours (T1),24 hours (T2),48 hours (T3) a point in time, MMSE and VAS score, record score as a result, and at the same time record four time point of the MAP, HR, SPO2.Outcome:Two groups of patients’ age, height, weight, sex, operation time, preoperative 24 hours MMSE score, anesthesia ASA classification comparison difference has no statistical significance (P> 0.05).Comparison within the group:Compared with T0, group Ⅰ,Ⅱ in T1, T2, T3, each point of the MAP, there was no statistically significant difference (P> 0.05);Compared with T0, group Ⅰ,Ⅱ in every point of T1, T2 and T3 HR, there was no statistically significant difference (P> 0.05);Compared with T0, Ⅰ, T1, T2 and T3 Ⅱ group each point of compare SPO2, there was no statistically significant difference (P> 0.05);Compared with T0, Ⅰ, T1, T2 and T3 group Ⅱ each point of the MMSE score.The difference was statistically significant (P< 0.05);Compared with T0, group Ⅰ,Ⅱ each point of T1, T2 and T3 of VAS increases, the difference was statistically significant (P< 0.05), And TO their generation, Ⅰ,Ⅱ group T1, T2, T3, each point of beta-amyloid in the blood (A beta) level has increased, the difference was statistically significant (P< 0.05).Comparison between groups:MAP comparison:comparison with group Ⅰ, group Ⅱ in every point of T1, T2 and T3 MAP is reduced, the difference was statistically significant (P< 0.05);HR:compared with group I,group Ⅱ in every point of T1, T2 and T3 HR is higher, the difference was statistically significant (P< 0.05);Compare SpO2, compared with group I, SpO2 group Ⅱ in T1, T2, T3, the value of three time points is higher;The difference was statistically significant (P< 0.05);Compared with group Ⅰ, VAS score comparison:grouup Ⅱ in every point of postoperative T1, T2 and T3 VAS score lower (P<0.05).MMSE comparison:Compared with group Ⅰ,group Ⅱ in TO point of MMSE score comparison, there was no statistically significant difference (P> 0.05).with group Ⅰ, group Ⅱ of each point in the T1, T2 and T3 MMSE score is higher, the difference was statistically significant (P< 0.05); Beta amyloid protein in the blood (beta) A horizontal comparison:Compared with Ⅰ group, Ⅱ group in TO point of beta-amyloid in the blood (beta) A horizontal comparison, there was no statistically significant difference (P> 0.05).Compared with Ⅰ group, in every point of T1, T2 and T3 Ⅱ group of beta-amyloid in the blood (A beta) level is low, the difference was statistically significant (P< 0.05);The number of self-control analgesia pump daily to press the comparison:Compared with group Ⅰ,group Ⅱ daily press group number is more, the difference was statistically significant (P< 0.05).Conclusions:Joint Sufentanil flurbiprofen ester, which is used for postoperative analgesia, has good analgesic effect on the elderly patients, and is better than that of sufentanil, which is used separately for the analgesic effect of postoperative analgesia. Joint ShuFen flurbiprofen ester, used for postoperative analgesia in elderly patients with a certain extent, reduce the occurrence of adverse reactions, but also can to a certain extent, significantly decreased the incidence of postoperative cognitive dysfunction...