右美托咪定对老年股骨颈骨折患者麻醉安全性的影响

Effects of Dexmedetomidine on Safety of Anesthesia in Older Patients with Femoral Neck Fracture

目的探讨右美托咪定对老年股骨颈骨折患者手术麻醉血流动力学及安全性的影响。方法选取2015年5月~2016年10月无锡市第九人民医院收治的老年股骨颈骨折患者72例,按随机数字表法分为对照组和观察组,每组各36例。两组均实施全身静脉麻醉,麻醉前分别给予咪达醴仑和右美托咪定,比较两组血流动力学、麻醉安全性和镇静效果。结果观察组在麻醉诱导后10min(T2)、30min(T3)、1h(T4)、气管插管拔管时(T5)的心率和平均动脉压明显低于对照组(P<0.05);观察组不良反应总发生率明显低于对照组;观察组麻醉诱导后T2、T3、T4、T5时间点的Ramsay评分明显高于对照组(P<0.05)。结论右美托咪定应用于老年股骨颈骨折手术麻醉中可有效稳定术中血流动力学,提高麻醉安全性,改善镇静效果,值得推广。

Objective To investigate the effects of dexmedetomidine on hemodynamics and safety of anesthesia in older patients with femoral neck fracture. Methods 72 older patients with femoral neck fracture in our hospital between May 2015 and October 2016 were selected and randomly divided into the control group and the observation group, 36 cases in each group. The control group was given midazolam and the observation group was given dexmedetomidine before intravenous general anesthesia was performed. The hemodynamics, safety and sedative effects in the two groups were recorded. Results The heart rate ( HR) and mean arterial pressure ( MAP) in the observation group were lower than those in the control group at T2 ( 10 min after induction of anesthesia) and T3 (30 min after induction of anesthesia), T4 ( 1 h after induction of anesthesia) and T5 ( immediately after tracheal extubation)(P <0. 05). The total incidence of adverse reactions in the observation group was lower than that in the control group ( P <0. 05). The Ramsay scores at T2 , T3 , T4 and T5 in the observation group were higher than those in the control group ( P <0. 05). Conclusion Dexmedetomidine can effectively stabilize intraoperative hemodynamics, improve safety and sedation effect in older patients with femoral neck fracture under general anesthesia.