右美托咪定对接受腰硬联合麻醉的老年股骨颈骨折患者情绪的影响  

Effect of dexmedetomidine on anxiety and depression in elderly patients undergoing combined spinal and epidural anesthesia for neck of femur fracture

作　　者：张勇[1,2] 尹宁 ZHANG Yong;YIN Ning(Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学,南京210000 [2]淮安市淮安医院麻醉科 [3]南京医科大学附属逸夫医院麻醉科

出　　处：《国际精神病学杂志》2024年第1期186-188,191,共4页Journal Of International Psychiatry

摘　　要：目的探讨右美托咪定(Dex)用于接受腰硬联合麻醉的老年股骨颈骨折患者的效果,及对其焦虑、抑郁情绪的影响。方法选取2020年1月~2023年1月我院收治的老年股骨颈骨折患者100例,随机分为观察、对照两组,各50例。麻醉成功后观察组输注Dex,对照组输注咪达唑仑。比较两组临床相关指标、血流动力学[心率(HR)、平均动脉压(MAP)]、Ramsay镇静评分、脑电双频谱(BIS)指数、焦虑自评表(SAS)和抑郁自评表(SDS)评分及不良率。结果观察组麻醉起效、睁眼时间均短于对照组,镇痛持续时间长于对照组(P<0.05)。两组HR、MAP水平和Ramsay评分、BIS指数在组间、时间点、组间·时间点比较均有差异(P<0.05)。术后3d,两组SDS、SAS评分均降低(P<0.05),且观察组低于对照组(P<0.05)。观察组不良反应发生率(18.00%)低于对照组(38.00%)(P<0.05)。结论Dex用于老年股骨颈骨折CSEA术,有效减少了疼痛引起的焦虑、抑郁情绪,且安全性较高。Objective To investigate the effect of dexmedetomidine(Dex)on anxiety and depression in elderly patients undergoing combined spinal epidural anesthesia(CSEA)for neck of femur fractures.Methods 100 elderly patients with neck of femur fracture admitted to our hospital from January 2020 to January 23 were randomly divided into observation group and control group,with 50 cases in each group.After successful anesthesia,Dex was administered to the observation group,while midazolam was administered to the control group.The clinically relevant indicators,hemodynamics[heart rate(HR),mean arterial pressure(MAP)],Ramsay sedation score,bispectral electroen-cephalogram(BIS)index,anxiety self-evaluation scale(SAS)and depression self-evaluation scale(SDS)scores,and adverse effects rate were compared between two groups.Results The anesthesia onset and eye opening time in the observation group were shorter than those in the control group,and the analgesic duration was longer than that in the control group(P<0.05).There were differences in HR,MAP levels,Ramsay scores,and BIS index between the two groups at different time points and time points(P<0.05).Three days after surgery,the SDS and SAS scores of both groups decreased(P<0.05),and the observation group was lower than the control group(P<0.05).The ad-verse reaction rate in the observation group(18.00%)was lower than that in the control group(38.00%)(P<0.05).Conclusion Dex is used for in elderly neck of femur fracture patients undergoing CSEA,which effectively reduces anxiety and depression caused by pain,and has high safety.

关 键 词：右美托咪定 老年股骨颈骨折 腰硬联合麻醉 焦虑 抑郁 

分 类 号：R749[医药卫生—神经病学与精神病学]