右美托咪定辅助镇痛对老年下肢骨折患者术后睡眠质量和恢复质量的影响  

The impact of dexmedetomidine-assisted analgesia on postoperative sleep quality and recovery quality in elderly patients with limb fractures patients

作　　者：赵慧玲 李正迁[2] 刘慧丽[2] 陈明安 白小强 薛英英 ZHAO Huiling;LI Zhengqian;LIU Huili;CHEN Mingan;BAI Xiaoqiang;XUE Yingying*(Department of Anesthesiology,Yan'an City Hospital of TCM,Shanxi Yan'an 716000,China;Department of Anesthesiology,Perking University Third Hospital,Beijing 100191,China)

机构地区：[1]延安市中医医院麻醉科,陕西延安716000 [2]北京大学第三医院麻醉科,北京100191

出　　处：《临床药物治疗杂志》2024年第9期50-53,共4页Clinical Medication Journal

基　　金：北京大学第三医院延安分院(延安市中医医院)种子基金科研项目(ZYY-ZZJJ-2022-011)。

摘　　要：目的探讨右美托咪定用于患者自控静脉镇痛(PCIA)对于下肢骨折行椎管内麻醉的老年患者术后睡眠质量和恢复质量的影响。方法选取2023年5月至2024年3月延安市中医医院椎管内麻醉下行下肢骨折手术的老年患者,根据随机数字表法分为观察组和对照组。PCIA方案:观察组给予舒芬太尼2μg/kg+右美托咪定2.5μg/kg+昂丹司琼8 mg,总容量100 mL;对照组给予舒芬太尼2μg/kg+昂丹司琼8 mg,总容量100 mL。记录阿森斯失眠量表(AIS)评分、疼痛数字评分(NRS)、Ramsay镇静评分、15项恢复质量(QoR-15)评分及不良反应发生情况。结果共纳入患者80例,每组40例。观察组术后第1、2、3天AIS评分显著低于对照组(均P<0.05),QoR-15评分高于对照组(均P<0.05),术后第6、12、24小时NRS评分显著低于对照组(均P<0.05);所有患者无低血压和呼吸抑制,恶心呕吐、心动过缓发生率差异无统计学意义(均P>0.05)。结论右美托咪定用于PCIA能够改善下肢骨折行椎管内麻醉的老年患者术后睡眠质量,提高术后恢复质量。Objective To investigate the effects of dexmedetomidine used in patient-controlled intravenous analgesia(PCIA)on the postoperative sleep quality and recovery quality in elderly patients who underwent lower limb fractures surgery with spinal anesthesia.Methods Elderly patients who underwent lower limb fracture surgery with spinal anesthesia at Yan'an City Hospital of TCM from May 2023 to March 2024 were selected and randomly divided into an observation group and a control group using the random number table method.PCIA protocol:observation group was given sufentanil 2.0μg/kg+dexmedetomidine 2.5μg/kg+ondansetron 8 mg,total volume 100 mL,control group was given sufentanil 2.0μg/kg+ondansetron 8 mg,total volume 100 mL.The Athens insomnia scale(AIS)score,numerical rating scale for pain(NRS),Ramsay sedation scale,15-item quality of recovery(QoR-15)score,and adverse reaction rate were recorded.Results A total of 80 patients were included,with 40 in each group.The AIS scores on postoperative days 1,2 and 3 were significantly lower in the observation group than those in the control group(all P<0.05),and the QoR-15 scores was higher than that in the observation group(all P<0.05).The NRS scores at 6,12,and 24 hours postoperatively were significantly lower in the observation group than those in the control group(all P<0.05);No patients experienced hypotension or respiratory depression,and the incidence of nausea and vomiting,and bradycardia showed no significant difference(all P>0.05).Conclusion The use of dexmedetomidine in PCIA can improve postoperative sleep quality and enhance recovery quality in elderly patients who underwent lower limb fracture surgery with spinal anesthesia.

关 键 词：右美托咪定 患者自控静脉镇痛 睡眠质量 椎管内麻醉 

分 类 号：R971.2[医药卫生—药品]