右美托咪定联合神经阻滞麻醉对PFNA手术老年患者应激及疼痛的影响  

Effects of Dexmedetomidine Combined with Nerve Block Anesthesia on Stress and Pain in Elderly Patients Undergoing PFNA Surgery

作　　者：谭嘉颖 梁杏 聂飞虎 TAN Jiaying;LIANG Xing;NIE Feihu(Xinyi People's Hospital,Xinyi 525300,China)

机构地区：[1]信宜市人民医院,广东信宜525300

出　　处：《中外医学研究》2025年第8期1-4,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：茂名市科技计划项目(210323204550784)。

摘　　要：目的:研究右美托咪定联合神经阻滞麻醉对股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)手术老年患者应激及疼痛的影响。方法:选取2020年11月—2023年10月在信宜市人民医院进行PFNA手术的80例老年患者,按病历号数字尾数单双随机法分为对照组和研究组,各40例,并以双盲法进行麻醉与手术。研究组采用右美托咪定联合神经阻滞麻醉。对照组采用生理盐水联合神经阻滞麻醉。比较两组患者入室时(T0)、麻醉开始时(T_(1))、手术开始15 min(T_(2))、手术开始30 min(T_(3))的视觉模拟评分法(visual analogue score,VAS)评分、Ramsay评分及血压(blood pressure,BP)、心率(heart rate,HR);记录并比较两组患者术中镇静、镇痛药用量及穿刺相关并发症。结果:研究组T_(2) VAS评分低于对照组,差异有统计学意义(P<0.05)。研究组T_(2) Ramsay评分高于对照组,差异有统计学意义(P<0.05)。研究组T_(2) BP、HR均低于对照组,差异有统计学意义(P<0.05)。研究组镇痛药用量显著少于对照组,术中穿刺并发症率低于对照组,差异有统计学意义(P<0.05)。结论:右美托咪定联合神经阻滞麻醉对PFNA手术老年患者的效果好,可降低术中患者应激反应,减少术中镇痛药用量,减少并发症。Objective:To investigate the effect of Dexmedetomidine combined with nerve block anesthesia on stress and pain in elderly patients undergoing proximal femoral nail antirotation(PFNA)surgery.Method:A total of 80 elderly patients who underwent PFNA surgery in Xinyi People's Hospital from November 2020 to October 2023 were collected.The patients were divided into control group and study group by single and even random method according to the mantissa of medical record number,40 cases in each group,and anesthesia and surgery were performed using the double-blind method.The study group was anesthetized by Dexmedetomidine combined with nerve block.The control group was given normal saline combined with nerve block anesthesia.Visual analogue score(VAS),Ramsay score,blood pressure(BP)and heart rate(HR)were compared between the two groups at the time of entry(T0),the beginning of anesthesia(T_(1)),15 min after surgery(T_(2))and 30 min after surgery(T_(3)).The amount of sedation and analgesic drugs and the complications related to puncture were recorded and compared between the two groups.Result:The VAS score of the study at T_(2) group was lower than that of the control group,and the difference was statistically significant(P<0.05).The Ramsay score of the study group at T_(2) was higher than that of the control group,and the difference was statistically significant(P<0.05).BP and HR of the study group at T_(2) were lower than those of the control group,and the differences were statistically significant(P<0.05).The dosage of analgesic drugs in the study group was significantly lower than that in the control group,and the complication rate of intraoperative puncture was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine combined with nerve block anesthesia has a good effect on elderly patients undergoing PFNA surgery,which can reduce the stress response of patients during the operation,reduce the amount of analgesic drugs during the operation,and reduce com

关 键 词：右美托咪定 神经阻滞 股骨近端防旋髓内钉 应激反应 疼痛 

分 类 号：R614[医药卫生—麻醉学]