右美托咪定联合硬膜外阻滞麻醉在老年髋部骨折患者中的应用效果  

Application effects of Dexmedetomidine combined with epidural block anesthesia in elderly patients with hip fractures

作　　者：卢长寿 罗剑 汪超 LU Changshou;LUO Jian;WANG Chao(Department of Anesthesiology of Rongji Orthopaedic Hospital,Yingtan 335000 Jiangxi,China)

机构地区：[1]鹰潭荣济骨科医院麻醉科,江西鹰潭335000

出　　处：《中国民康医学》2025年第8期72-74,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察右美托咪定联合硬膜外阻滞麻醉在老年髋部骨折患者中的应用效果。方法:选取2022年9月至2024年2月该院收治的104例老年髋部骨折患者进行前瞻性研究,采用抽签法将其分为研究组和对照组各52例。对照组采用硬膜外阻滞麻醉,研究组在对照组基础上采用右美托咪定麻醉,比较两组围手术期指标(麻醉起效时间、完全苏醒时间、谵妄发生率)水平、谵妄持续时间、不同时间血流动力学指标[心率、平均动脉压(MAP)]水平和麻醉不良反应发生率。结果:研究组麻醉起效时间、完全苏醒时间均短于对照组,谵妄发生率低于对照组,差异有统计学意义(P<0.05);研究组谵妄持续时间短于对照组,差异有统计学意义(P<0.05);麻醉前5 min,两组心率、MAP水平比较,差异均无统计学意义(P>0.05);麻醉后30 min、术毕时,两组MAP水平均低于麻醉前5 min,但研究组高于对照组,差异有统计学意义(P<0.05);麻醉后30 min,两组心率水平均低于麻醉前5 min,但研究组高于对照组,差异有统计学意义(P<0.05);术毕时,两组心率水平均高于麻醉前5 min,但研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定联合硬膜外阻滞麻醉应用于老年髋部骨折患者可改善围手术期指标和血流动力学指标水平,缩短谵妄持续时间,效果优于单纯硬膜外阻滞麻醉。Objective:To observe application effects of Dexmedetomidine combined with epidural block anesthesia in elderly patients with hip fractures.Methods:A prospective study was conducted on 104 elderly patients with hip fractures admitted to this hospital from September 2022 to February 2024.According to the lottery method,they were divided into study group and control group,52 cases in each group.The control group was treated with epidural block anesthesia,while the study group was treated with Dexmedetomidine anesthesia on the basis of that of the control group.The perioperative indexes(onset time of anesthesia,complete recovery time,incidence of delirium)levels,the duration of delirium,the hemodynamic indexes[heart rate,mean arterial pressure(MAP)]levels at different time,and the incidence of adverse reactions of anesthesia were compared between the two groups.Results:The onset time of anesthesia and the complete recovery time in the study group were shorter than those in the control group,the incidence of delirium was lower than that in the control group,and the differences were statistically significant(P<0.05).The duration of delirium in the study group was shorter than that in the control group,and the difference was statistically significant(P<0.05).5 min before anesthesia,there were no significant differences in the heart rate and MAP levels between the two groups(P>0.05).30 min after anesthesia and at the end of the surgery,the MAP levels of the two groups were lower than those 5 min before anesthesia,but those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).30 min after anesthesia,the heart rate levels of the two groups were lower than those 5 min before anesthesia,but that in the study group was higher than that in the control group,and the differences were statistically significant(P<0.05).At the end of the surgery,the heart rate levels of the two groups were higher than 5 min before anesthesia,but that in the study group was lower t

关 键 词：右美托咪定 硬膜外阻滞 老年 髋部骨折 血流动力学 谵妄 

分 类 号：R614[医药卫生—麻醉学]