右美托咪定联合罗哌卡因对老年膝关节置换术后睡眠质量的影响

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Effect of Dexmedetomidine Combined with Ropivacaine on Sleep Quality after Total Knee Arthroplasty in Elderly Patients

WANGDongsheng，YURu

（TheFirstAffiliated Hospital ofBengbu Medical University，Bengbu 233OoO，China）

AbstractObjective：Toanalyzetheefectsof diferent postoperativeanalgesiaregimensonsleepqualityinelderlypatientsundergoing totalkneearthroplasty（TKA）.Methods：Atotalof38elderlyTKApatientsadmitedfromJanuary2O23toDecember 2023 were includedasthecontrol group，and42 patientsadmitedfromJanuary2024 to January2O25were includedas theobservationgroup.Thecontrol groupreceived postoperativeanalgesiawith ropivacainealone，whiletheobservation groupreceived dexmedetomidinecombinedwithropivacaine.The Pitsburgh SleepQualityIndex（PSQI）and Montreal CognitiveAssessmnt（MoCA） scores were compared between the two groups. Results：At postoperative day 1 and day 2，PSQI scores in both groups were higherthanthosebeforesurgery，andscoresatday2werelowerthanthoseatday1.Theoservation groupexhibitedsignificantly lower PSQI scores at both postoperative time points compared with the control group（ P<0.05） .At postoperative day 1，MoCA （20 scores inboth groups werelowerthanthose before surgery.At postoperativeday7，the MoCA scoreof theobservationgroup increasedcompared withpostoperativeday1，whereas the MoCAscoreofthecontrolgroupremainedlowerthanthepreoperativelevel.MoCscores intheobservationgroupweresignificantlyhigherthanthoseinthecontrolgroupatpostoperativedayandday （ P<0.05 ）. Conclusion：Inelderlypatientsundergoing total kneearthroplasty，thecombinedanalgesia regimenofdexmedetomidine and ropivacaine can aleviate postoperative decline in sleep quality and promote recovery of cognitive function.

KeywordsElderlypatients；Dexmedetomidine；Ropivacaine;；Total kneearthroplasty；Slpquality；Cognitive function;Postoperative analgesia； Perioperative neurocognitive disorder

中图分类号：R684;R338.63 文献标识码：A doi：10.3969/j.issn.2095-7130.2025.08.012

膝关节置换术是治疗膝关节疾病的有效手段，可改善患者关节功能。（剩余4495字）