老年髋部骨折手术腰麻联合硬膜外麻醉成功后静脉泵注右美托咪定对患者血流动力学的影响  

Effect of intravenous pumping of dexmedetomidine on hemodynamics in elderly patients with hip fracture surgery after successful combined spinal-epidural anesthesia

作　　者：盛锦华 吴良丰 王剑军 Sheng Jin-hua;Wu Liang-feng;Wang Jian-jun(Department of Anesthesiology,Yushan Hospital of Traditional Chinese Medicine,Shangrao 334700,Jiangxi,China)

机构地区：[1]江西省玉山县中医院麻醉科,江西上饶334700

出　　处：《四川生理科学杂志》2024年第4期810-812,875,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探究老年髋部骨折手术腰麻联合硬膜外麻醉成功后静脉泵注右美托咪定的效果。方法:选取2018年6月至2023年8月我院收治髋部骨折老年患者70例,随机分为对照组和观察组,每组各35例。对照组给予常规腰麻联合硬膜外麻醉,观察组在麻醉成功后静脉泵注右美托咪定。观察两组患者血流动力学变化,麻醉后即刻(T0)、制造入路切口(T1)、置换操作/空心钉置入操作后(T2)、术毕缝皮(T3)时收缩压(Systolic Blood Pressure,SBP)、舒张压(Diastolic Blood Pressure,DBP)、心率(Heart Rate,HR)、血氧饱和度(Oxyhemoglobin Saturation,SpO_(2))水平;镇静效果,包括T0、T1、T2、T3时Richmond镇静评分(Richmond Agitation and Sedation Scale,RASS);麻醉药物不良反应发生率。结果:T1、T2、T3时观察组患者SBP、DBP、HR水平低于对照组(P<0.05);两组患者各时间点SpO_(2)水平、镇静适度率相近;两组患者麻醉药物不良反应发生率相近。结论:老年髋部骨折手术腰麻联合硬膜外麻醉成功后静脉泵注右美托咪定镇静镇痛效果良好,且安全性高。Objective:To explore the effect of intravenous pumping of dexmedetomidine on hemodynamics after successful combined spinal-epidural anesthesia for elderly hip fractures.Methods:70 elderly patients with hip fractures admitted to our hospital from June 2018 to August 2023 were selected and divided into control group and observation group randomly,with 35 cases in each group.Control group was given conventional combined spinal-epidural anesthesia,and observation group was given intravenous pumping of dexmedetomidine after successful anesthesia.The two groups were observed in terms of hemodynamic changes[including systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and oxyhemoglobin saturation(SpO_(2))immediately after anesthesia(T0),after incision making(T1),after replacement/nail implantation(T2)and at skin suture after the end of surgery(T3)],sedation effect(Richmond Agitation and Sedation Scale(RASS)at T0,T1,T2 and T3),and adverse reactions of anesthetic drugs.Results:The SBP,DBP and HR in observation group were lower than those in control group at T1,T2 and T3(P<0.05).The SpO_(2) and moderate rate of sedation were similar between the two groups of patients.The incidence rates of adverse reactions of anesthetic drugs were similar between the two groups.Conclusion:Intravenous pumping of dexmedetomidine has good sedation effect and analgesia effect and high safety after successful combined spinal-epidural anesthesia in elderly patients undergoing hip fracture surgery.

关 键 词：老年患者 髋部骨折 腰麻 硬膜外麻醉 右美托咪定 血流动力学 

分 类 号：R614[医药卫生—麻醉学]