小剂量多巴酚丁胺对老年单肺通气患者术中脑氧饱和度变化率与术后谵妄发生的影响

doi:10.3969/j.issn.2095-9400.2021.04.005

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Abstract Objective: To explore the effect of low-dose dobutamine on intraoperative rScO2 and POD in elderly patients undergoing one-lung ventilation. Methods: Sixty-four elderly patients undergoing OLV under general anesthesia were randomly divided as observation group (group O) and control group (Group C), with 32 cases in each. Dobutamine hydrochloride or normal saline was injected intravenously after OLV, with the speed of 1.5 μg/(kg·min) until the end of OLV. In addition to routine monitoring, the rScO2 was recorded before anesthesia (T1), 5 minutes before OLV (T2), 15 minutes after OLV (T3), 30 minutes after OLV (T4), 45 minutes after OLV (T5), and 15 minutes after OLV (T6). The agitation in recovery period, VAS and POD incidence of the two groups were observed on the 1st, 3rd and 7th day after operation (or before discharge). The change rate of rScO2 in both groups was calculated. The correlation between the change rate of rScO2 and CAM score, Riker sedation-Agitati score, POD were analyzed. The independent risk factors of POD were analyzed by Logistic regression. Results: During the period of OLV, the rScO2 of group C decreased gradually with time (P<0.05), while group O had significant rScO2 decrease at T5 (P<0.05). The HR and rScO2 at T5 in group O were higher than those in group C (P<0.05). The change rate of rScO2, agitation during recovery period, CAM score and incidence of POD in group O were lower than those in group C (P<0.05). The change rate of rScO2 was positively correlated with Riker sedation-Agitati score during recovery period and CAM score on 1st day after operation. Logistic regression analysis showed that the increase of rScO2 change rate, diabetes history and old age were independent risk factors for POD. Conclusion: Low-dose dobutamine can reduce the change rate of cerebral oxygen saturation and postoperative delirium in elderly patients with one-lung ventilation.

Key words： dobutamine one-lung ventilation elderly cerebral oxygen saturation postoperative delirium

Received: 16 October 2020

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	FANG Ping
	LOU Yingying
	SUN Gangqiang
	WANG Jingyu
	XU Guodong

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https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2021.04.005 OR https://xb.wmu.edu.cn/EN/Y2021/V51/I4/282

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