纳美芬处理腹腔镜胆囊切除术治疗胆囊结石患者苏醒和认知功能变化研究*

doi:10.3969/j.issn.1672-5069.2024.05.035

Abstract

Abstract: Objective The aim of this study was to investigate effects of nalmefene on cognitive function recovery after anesthesia in patients with cholecystolithiasisundergoing laparoscopic cholecystectomy (LC). Methods 94 patients with gallstones were enrolled in our hospital between February 2022 and December 2023, and all underwent LC surgery. At end of conventional anesthesia, patients were randomly assigned to receive nalmefene in observation (n=47) or normal saline in control (n=47) to improve recovery. Emergence agitation was evaluated by Richmond sedation-agitation scale (RSAS), postoperative pain was evaluated by visual analogue scale (VAS), and postoperative cognitive function was evaluated by mini-mental state examination (MMSE). Serum soluble protein-100β (S100β) and neuron-specific enolase (NSE) levels were detected by ELISA. Results Spontaneous respiration recovery, eye opening, extubation time and orientation recovery in observation group were (7.1±1.3) min, (8.5±1.4)min, (10.5±1.9)min and (13.6±2.2)min, all significantly shorter than [(9.3±1.5)min, (10.4±1.7)min, (14.3±2.8)min and (18.4±2.7)min, respectively, P＜0.05] in the control; there was no significant difference respect to RSAS scores between the two groups (P＞0.05), while 30min, 60min and 3hours after extubation,VAS scores in the observation were (2.8±0.5)points, (3.2±0.8)points and (3.5±0.4)points, all much lower than [(3.8±0.9)points, (4.1±0.7)points and (4.3±0.6)points, P＜0.05] in the control; one and three days after operation, MMSE score in the observation were (26.8±1.0)points and (27.7±0.7)points, both significantly higher than [(25.1±0.9)points and (26.0±0.8)points, P＜0.05] in the control; one day after surgery, serum NSE and S100β levels in the observation were (14.7±2.1)μg/L and (155.6±17.8)pg/mL, both much lower than [(17.3±2.7)μg/L and (169.5±20.4)pg/mL, P＜0.05]in the control group. Conclusion Administration of nalmefene at end of conventional anesthesia could relieve postoperative pain and accelerate cognitive function recovery in patients with cholecystolithiasis after LC operation.

Key words: Cholecystolithiasis, Laparoscopic cholecystectomy, Anesthesia, Nalmefene, Recoveryquality, Cognitive function

Xiang Hong, Ye Li, Huang Jianfeng. Nalmefene improves cognitive function recovery after anesthesia in patients with cholecystolithiasis undergoing laparoscopic cholecystectomy[J]. Journal of Practical Hepatology, 2024, 27(5): 785-788.

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Nalmefene improves cognitive function recovery after anesthesia in patients with cholecystolithiasis undergoing laparoscopic cholecystectomy

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