右美托咪定在腰硬联合麻醉中对老年骨科手术麻醉效果及血压的影响  

Effect of Dexmedetomidine in Combined Spinal-Epidural Anesthesia on the Anesthesia Effect and Blood Pressure of Elderly Orthopedic Surgery

作　　者：康英华 KANG Yinghua(Department of Anesthesiology,Fuxin Central Hospital,Fuxin 123000,China)

机构地区：[1]阜新市中心医院麻醉科,辽宁阜新123000

出　　处：《中国医药指南》2023年第2期61-64,共4页Guide of China Medicine

摘　　要：目的 探究右美托咪定在腰硬联合麻醉中对老年骨科手术患者的整体麻醉效果和血压等产生的影响。方法 将2021年1月至2022年1月到我院治疗的45例老年骨科手术患者设为观察组,另将同期到我院进行治疗的43例老年骨科手术患者设为对照组。对照组患者以重布比卡因辅助全身麻醉方案开展麻醉,观察组患者则通过腰硬联合麻醉方案应用右美托咪定开展麻醉,对不同麻醉以后的患者在不同时间段的血压、麻醉优良率、麻醉后的不良反应发生率、不同时间段的疼痛等进行统计学分析并开展比较。结果 (1) T_(0)时,两组患者的血压水平差异无统计学意义(P>0.05),T_(1)、T_(2)、T_(3)时,相比对照组而言,观察组的血压水平更加稳定,数据差异有统计学意义(P<0.05)。(2)麻醉后观察组(42例,占93.33%)的麻醉优良率比对照组(37例,占86.05%)患者更高,数据差异有统计学意义(P<0.05)。(3)麻醉后观察组(1例,占2.22%)的不良反应发生率相比对照组(8例,占18.60%)更低(P<0.05)。(4)手术结束后,两组患者的疼痛评分差异无统计学意义(P>0.05),术后4 h、术后24 h、术后72 h,观察组的疼痛评分明显比对照组更轻,数据差异有统计学意义(P<0.05)。结论 腰硬联合麻醉中应用右美托咪定的方案开展麻醉应用于老年骨科患者手术中,可有效的稳定患者的血压水平,提升麻醉的优良率,可实现降低麻醉不良反应的目的,控制术后疼痛。Objective To explore the effect of dexmedetomidine in combined spinal-epidural anesthesia on the overall anesthesia effect and blood pressure of elderly patients with orthopedic surgery. Methods A total of 45 elderly orthopedic surgery patients who were treated in our hospital from January 2021 to January 2022 were set as the observation group, and 43 elderly orthopedic surgery patients who were treated in our hospital during the same period were set as the control group. Patients in the control group were anesthetized with heavy bupivacaine-assisted general anesthesia, while patients in the observation group were anesthetized with dexmedetomidine through combined spinal-epidural anesthesia. The excellent and good rate of anesthesia, the incidence of adverse reactions after anesthesia, and the pain in different time periods after anesthesia were statistically analyzed and compared. Results(1) At T_(0), there was no significant difference in blood pressure levels between the two groups(P>0.05). At T_(1), T_(2), and T_(3), compared with the control group,the blood pressure levels in the observation group were more stable, and the difference was statistically significant(P<0.05).(2) After anesthesia, the excellent and good rate of anesthesia in the observation group(42 cases, accounting for 93.33%) was higher than that in the control group(37 cases, accounting for 86.05%), and the difference was statistically significant(P<0.05).(3) After anesthesia,the incidence of adverse reactions in the observation group(1 case, accounting for 2.22%) was lower than that in the control group(8 cases, accounting for 18.60%), and the difference was statistically significant(P<0.05).(4) After the operation, there was no significant difference in the pain scores between the two groups(P>0.05). The pain scores of the observation group were significantly lighter than those of the control group at 4 hour, 24 hour, and 72 hour after surgery, and the data were different, and the difference was statistically significant(P<0.05).Conclusion

关 键 词：右美托咪定 腰硬联合麻醉 老年 骨科 血压水平 手术 不良反应 

分 类 号：R473.6[医药卫生—护理学] R614[医药卫生—临床医学]