右美托咪定用于老年高血压患者椎管内麻醉的临床研究

Clinical research of application of dexmedetomidine during spinal anesthesia in elderly patients with hypertension

目的探讨右美托咪定用于老年高血压患者椎管内麻醉的临床效果及其安全性。方法选择行下肢骨折内固定术老年高血压患者68例,按随机数字表法分为试验组(38例)和对照组(30例),患者行腰硬联合麻醉后,试验组静脉泵注右美托咪定至手术结束,对照组以生理盐水静脉泵注至手术结束。比较两组患者术中生命体征、Ramsay镇静评分、麻醉效果、硬膜外总用药量及不良反应发生情况。结果试验组较对照组术中血流动力学变化更稳定,Ramsay镇静评分高,麻醉效果优,硬膜外总用药量更少,且不良反应的发生率更低,差异均有统计学意义(P<0.05)。结论右美托咪定减少老年高血压患者硬膜外总用药量,麻醉效果良好,且无明显不良反应,用于老年高血压患者椎管内麻醉是安全、有效的。

Objective To investigate the anesthetic effect and safety of application of dexmedetomidine during spinal anesthe -sia in elderly patients with hypertension .Methods Sixty-eight cases of elderly patients with hypertension under combined spinal epi -dural anesthesia for lower limb fracture internal fixation operation were randomly divided into experimental group （38 cases）and control group（30 cases）.The experimental group received an intravenous infusion of dexmedetomidine until the operation was over .The control group was administrated with physiological saline until the end of operation .Vital signs during operation ,Ramsay sedation score ,effect of anesthesia ,total dosage of epidural and adverse reaction were observed and compared .Results Compared with the control group ,pa-tients in the experimental group showed more stable hemodynamics during the operations ;their Ramsay sedation score was higher;anes-thesia effect was better;total dosage of epidural was lower and adverse reaction was less （ all P〈0.05 ） .Conclusion Dexmedetomidine can significantly reduce the total dosage of epidural during spinal anesthesia in elderly patients with hypertension and has a good anes -thetic effect but no obvious adverse reaction .It was a kind of safe and feasible anesthetics for spinal anesthesia in these patients .