右美托咪定应用于老年髋关节置换术脊髓麻醉联合硬膜外麻醉中对患者血流动力学水平的影响评价  

Evaluation of the Effect of Dexmedetomidine on Hemodynamic Levels in Elderly Patients Undergoing Hip Replacement Surgery Under Spinal Anesthesia Combined with Epidural Anesthesia

作　　者：刘国林 林武 郑洪棋 LIU Guolin;LIN Wu;ZHENG Hongqi(Department of Surgical Anesthesiology,Fuzhou Lianjiang County General Hospital of Fujian Province,Fuzhou,Fujian,350500,China)

机构地区：[1]福建省福州市连江县总医院手术麻醉科,福建福州350500

出　　处：《中外医疗》2024年第32期107-111,共5页China & Foreign Medical Treatment

摘　　要：目的探讨右美托咪定应用于老年髋关节置换术脊髓麻醉联合硬膜外麻醉中对患者血流动力学水平的影响评价。方法方便选取2023年1月—2024年3月福建省福州市连江县总医院收治的82例行髋关节置换术老年患者为研究对象,根据麻醉方式的不同分为两组,每组41例,对照组单用脊髓麻醉联合硬膜外麻醉,在此基础上,观察组在麻醉前静脉泵注右美托咪定。对比两组的血流动力学指标、炎症和应激效应指标、术后疼痛、认知功能和不良反应。结果观察组麻醉时的心率、血压均高于对照组,且观察组指标变化幅度低于对照组,差异有统计学意义(P均<0.05)。术后24 h,观察组的肿瘤坏死因子-α、白细胞介素-6、皮质醇、去甲肾上腺素水平均低于对照组,差异有统计学意义(P均<0.05)。术后6 h、12 h、24 h时,观察组的视觉模拟疼痛评分均低于对照组,差异有统计学意义(P均<0.05)。术后4 h、8 h、12 h,观察组的简易精神状态检查量表评分均高于对照组,差异有统计学意义(P均<0.05)。观察组不良反应总发生率为4.88%(2/41),低于对照组的21.95%(9/41),差异有统计学意义(χ2=5.145,P<0.05)。结论右美托咪定应用于老年髋关节置换术患者脊髓麻醉联合硬膜外麻醉中的效果显著,能提高术中血流动力学稳定性,缓解术后患者的疼痛,认知功能在一定程度上得到保护,不良反应相对较少。Objective To investigate the effect of dexmedetomidine on the hemodynamic level of elderly patients undergoing hip replacement surgery under spinal anesthesia combined with epidural anesthesia.Methods A total of 82 elderly patients who underwent hip replacement surgery in Fuzhou Lianjiang County General Hospital of Fujian Province from January 2023 to March 2024 were conveniently selected as the research objects.According to the different anesthesia methods,they were divided into two groups,with 41 cases in each group.The control group was given spinal anesthesia combined with epidural anesthesia alone.On this basis,the observation group was given intravenous infusion of dexmedetomidine before anesthesia.The hemodynamic indexes,inflammation and stress response indicators,postoperative pain,cognitive function and adverse reactions were compared between the two groups.Results The heart rate and blood pressure during anesthesia in the observation group were higher than those in the control group,and the changes amplitude of the observation group was lower than that of the control group,the differences were statistically significant(all P<0.05).At 24 h after operation,the levels of tumor necrosis factor-α,interleukin-6,cortisol and norepinephrine in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).At 6 h,12 h and 24 h after operation,the Visual Analogue Scale scores of the observation group was lower than that of the control group,and the differences were statistically significant(all P<0.05).At 4 h,8 h and 12 h after operation,the scores of Mini-mental State Examination in the observation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).The total incidence of adverse reactions in the observation group was 4.88%(2/41),which was lower than 21.95%(9/41)in the control group,and the difference was statistically significant(χ2=5.145,P<0.05).Conclusion The application of dexmedeto

关 键 词：老年 髋关节置换术 脊髓麻醉 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]