不同剂量DEX对老年髋关节置换术后生活质量的影响

Effects of different doses of DEX on quality of life after hip arthroplasty in elderly patients

目的:分析不同剂量右美托咪定(dexmedetomidine,DEX)对老年髋关节置换患者术后生活质量的影响。方法:全身麻醉下髋关节置换术的老年患者108例,随机分为三组,每组36例,分别为M1组(小剂量组)、M2组(大剂量组)、M3组(对照组),记录三组患者围术期生活质量评分、术中各时间点脑电双频指数(bispectral index,BIS)以及手术维持时间、麻醉维持时间、失血量、停药-睁眼时间、停药-拔管时间等术中指标。结果:术后7天:M1、M2组躯体健康、心理健康评分高于M3组;在术中30 min、术毕时,M1组BIS值低于M3组,M2组BIS值低于M1、M3两组;M2组停药-睁眼时间、停药-拔管时间长于M1、M3组。结论:老年髋关节置换患者选用0.4 ug/kg;h的右美托咪定,在获得较好麻醉效果的同时能有效改善老年患者术后的生活质量,值得临床大量推广。

Objective To analyze the effects of different doses of dexmedetomidine on quality of life after hip arthroplasty in elderly patients.Methods A total of 108 elderly patients undergoing hip arthroplasty under general anesthesia were randomly divided into three groups with 36 patients in each group.They are M1 group(low-dose group),M2 group(high-dose group),and M3 group(control group).Perioperative quality of life score,bispectral index(BIS)at each time point during the operation,operation maintenance time,anesthesia maintenance time,blood loss,drug discontinued-eye opening time,drug discontinued-extubation time and other intraoperative indexes of the three groups were recorded.Results 7 days after surgery:the physical health and mental health scores of M1 and M2 groups were higher than those of M3 group.At 30 min and after operation,BIS value of M1 group was lower than that of M3 group,and BIS value of M2 group was lower than that of M1 and M3 groups.The discontinuation-eye opening time and discontinuation-extubation time in M2 group were longer than those in M1 and M3 groups.Conclusion 0.4 ug/kg.h dexmedetomidine is used for elderly patients with hip arthroplasty,which can effectively improve the postoperative quality of life of elderly patients while obtaining better anesthetic effect,and is worthy of extensive clinical promotion.