右美托咪定用于老年髋部骨折患者麻醉的临床研究  

Clinical trial of dexmedetomidine in anesthesia of elderly patients with hip fracture

作　　者：王辉[1] 王玲[1] 李浩[2] WANG Hui;WANG Ling;LI Hao(Department of Anesthesiology,Anqing First People’s Hospital Affiliated to Anhui Medical University,Anqing 246000,Anhui Province,China;Department of Orthopedics,Anqing First People’s Hospital Affiliated to Anhui Medical University,Anqing 246000,Anhui Province,China)

机构地区：[1]安徽医科大学附属安庆第一人民医院麻醉科,安徽安庆246000 [2]安徽医科大学附属安庆第一人民医院骨科,安徽安庆246000

出　　处：《中国临床药理学杂志》2023年第8期1082-1085,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察右美托咪定用于老年髋部骨折患者麻醉的临床疗效及安全性。方法将老年髋部骨折患者用随机数字表法分为对照组和试验组。2组均进行腰麻联合硬膜外麻醉,用脑脊液将0.5%罗哌卡因1.5 mL稀释至3 mL后注入蛛网膜下腔,后对硬膜外腔间断性推注1.5%利多卡因5 mL维持麻醉;麻醉成功后试验组静脉泵注右美托咪定0.4μg·kg^(-1),速度为0.2μg·kg^(-1)·h^(-1);对照组按照相同的方法静脉泵注等量0.9%NaCl。2组术后均给予静脉自控镇痛,并观察24 h。比较2组麻醉效果、血流动力学指标、疼痛、应激指标及药物不良反应发生情况。结果对照组和试验组各45例。试验组和对照组的Ramsay镇静评分分别为(1.17±0.22)和(3.21±0.44)分,差异有统计学意义(均P<0.05)。手术完成时,试验组和对照组的心率(HR)分别为(82.04±6.48)和(91.27±6.58)times·min^(-1);平均动脉压(MAP)分别为(93.62±9.36)和(105.58±11.47)mmHg,差异均有统计学意义(均P<0.05)。术后24 h,试验组和对照组的血清P物质(SP)水平分别为(159.84±19.38)和(203.28±32.47)ng·mL^(-1),去甲肾上腺素(NE)水平分别为(349.85±36.27)和(409.48±52.19)ng·mL^(-1),皮质醇(COR)水平分别为(152.34±16.48)和(193.27±21.47)μg·L^(-1),差异均有统计学意义(均P<0.05)。试验组药物不良反应发生率为17.78%,对照组为20.00%,差异无统计学意义(P>0.05)。结论用右美托咪定对老年髋部骨折患者进行麻醉,可有效改善患者血流动力学指标,降低患者术后疼痛及机体应激,具有较好的麻醉效果,同时安全性良好。Objective To analyze the clinical efficacy and safety of dexmedetomidine in anesthesia of elderly patients with hip fracture。Methods Ninety elderly patients with hip fracture were divided into control group and treatment group by random number table method.Both groups received lumbar anesthesia combined with epidural anesthesia 0.5%ropivacaine 1.5 mL was diluted to cerebrospinal fluid 3 mL and injected into the subarachnoid space.After that,1.5%lidocaine 5 mL was injected into the epidural space periodically to maintain anesthesia。After successful anesthesia,treatment group was injected with dexmedetomidine 0.4μg·kg^(-1)by intravenous pump at a rate of 0.2μg·kg^(-1)·h^(-1),while control group was injected with 0.9%NaCl by intravenous pump with the same method.Both groups were given intravenous controlled analgesia and observed for 24 h after surgery.The anesthesia effect,hemodynamic indexes,pain and stress indexes and the occurrence of adverse drug reactions were compared between the two groups.Results There were 45 cases in control group and 45 cases in treatment group.Ramsay sedative scale in treatment group and control group were 1.17±0.22 and 3.21±0.44,the difference between groups were statistically significant(P<0.05).Heart rate(HR)in treatment group and control group at the end of the operation were(82.04±6.48)and(91.27±6.58)times·min^(-1);mean arterial pressure(MAP)were(93.62±9.36)and(105.58±11.47)mmHg,the differences between groups were statistically significant(all P<0.05).The levels of serum substance P(SP)24 h after operation in treatment group and control group were(159.84±19.38)and(203.28±32.47)ng·mL^(-1);the levels of serum norepinephrine(NE)were(349.85±36.27)and(409.48±52.19)ng·mL^(-1);the levels of serum cortisol(COR)were(152.34±16.48)and(193.27±21.47)μg·L^(-1),the differences between groups were statistically significant(all P<0.05).During the observation period,the incidence of total adverse drug reactions in treatment group was 17.78%,which was not significantly diffe

关 键 词：右美托咪定 髋部骨折 老年 麻醉 

分 类 号：R971[医药卫生—药品]