关键词: 七氟烷, 吸入浓度, 术后谵妄, 老年患者

Abstract: ［Abstract］ Objective To observe the effect of inhaling different concentrations of sevoflurane on postoperative delirium in elderly patients undergoing hip replacement surgery. Methods In this respective research, 100 elderly patients, aged 65 to 75 years and more than 6 years of education, were performed the hip arthroplasty in our hospital. The grouped patients were assigned to two groups, low concentration group（group L）and high concentration group（group H）, with 50 patients in each group. The concentration of sevoflurane inhalation in the L group was 1.5%, and the sevoflurane inhalation concentration in the H group was 3%. Chinese revised version of delirium assessment scale（CAM?CR） was used to assess the incidence of delirium in the preoperative day 1, postoperative day 1, postoperative day 2, and postoperative day 3. Peripheral venous blood was taken before anesthesia induction（T0）, 1 h postoperatively（T1）, 6 h postoperatively（T2）, 1 day postoperatively（T3）extraction of peripheral venous blood for detecting the concentration of S100β protein. Results The total incidence of postoperative delirium（POD）in 3 days after operation in group H was significantly higher than that in group L （P<0.05）. The S100β protein level of T1 and T2 in group H was significantly higher than that in L group（P<0.05）, and the time of recovery was obviously prolonged（P<0.05）. Conclusions The 3% concentration of sevoflurane inhaled combined with remifentanil could lead to an increase in the incidence of POD in the elderly patients undergoing hip replacement. 1.5% sevoflurane inhalation combined with remifentanil has higher safety.

Key words: sevoflurane, elderly patients, inhalation concentration, postoperative delirium