腰硬联合麻醉术中持续静脉泵注右美托咪定在老年骨科手术患者中的应用效果  

Application Effect of Intraoperative Continuous Intravenous Infusion of Dexmedetomidine Under Combined Spinal and Epidural Anesthesia in Elderly Patients Undergoing Orthopedic Surgery

作　　者：刘朝阳 Liu Chaoyang(Department of Anesthesiology,Xinyi People's Hospital,Xinyi 221400,Jiangsu Province,China)

机构地区：[1]新沂市人民医院麻醉科,江苏徐州221400

出　　处：《中国社区医师》2025年第5期18-20,共3页Chinese Community Doctors

摘　　要：目的:分析腰硬联合麻醉术中持续静脉泵注右美托咪定在老年骨科手术患者中的应用效果。方法:选择2021年1月—2023年1月于新沂市人民医院接受骨科手术治疗的老年患者62例为研究对象,随机分为对照组和观察组,每组31例。两组均采取腰硬联合方式麻醉,对照组术中持续静脉泵注氯化钠注射液和丙泊酚维持麻醉,观察组术中持续静脉泵注右美托咪定注射液维持麻醉。比较两组生理指标、认知功能、疼痛程度及并发症发生情况。结果:麻醉30 min后,两组心率、平均动脉压、血氧饱和度均降低,且观察组低于对照组(P<0.05)。术后4 h、24 h及72 h,两组认知功能评分均高于术毕时,且观察组高于对照组(P<0.001);两组疼痛评分均高于术毕时,但观察组低于对照组(P<0.001)。观察组并发症总发生率低于对照组(P=0.031)。结论:腰硬联合麻醉术中持续静脉泵注右美托咪定在老年骨科手术患者中的应用效果较好,能够稳定其生命体征,减轻疼痛,改善患者的认知功能。Objective:To analyze the application effect of intraoperative continuous intravenous infusion of dexmedetomidine under combined spinal and epidural anesthesia in elderly patients undergoing orthopedic surgery.Methods:A total of 62 elderly patients who underwent orthopedic surgery treatment in Xinyi People's Hospital from January 2021 to January 2023 were selected as the study subjects.They were randomly divided into control group and observation group,with 31 cases in each group.Both groups were subject to combined spinal and epidural anesthesia.The control group was given intraoperative continuous intravenous infusion of sodium chloride injection and propofol for maintenance of anesthesia,and the observation group was given intraoperative continuous intravenous infusion of dexmedetomidine injection for maintenance of anesthesia.Physiological indicators,cognitive function,pain level and complications were compared between the two groups.Results:After 30 min of anesthesia,the heart rate,mean arterial pressure and blood oxygen saturation in two groups decreased,and these parameters in the observation group were lower than those in the control group(P<0.05).At 4 h,24 h and 72 h after surgery,the cognitive function scores in the two groups were higher than those at the end of surgery,and the scores in the observation group were higher than those in the control group(P<0.001).The pain scores in the two groups were higher than those at the end of surgery,but the scores in the observation group were lower than those in the control group(P<0.001).The total incidence of complications in the observation group was lower than that in the control group(P=0.031).Conclusion:Intraoperative continuous intravenous infusion of dexmedetomidine under combined spinal and epidural anesthesia has a good effect in elderly patients undergoing orthopedic surgery,and can stabilize their vital signs,relieve pain and improve patients'cognitive function.

关 键 词：腰硬联合麻醉 右美托咪定 谵妄 

分 类 号：R614[医药卫生—麻醉学]