小剂量右美托咪定在腰硬联合麻醉老年患者髋关节置换术中的应用效果

Application effect of low-dose Dexmedetomidine on hip replacement in elderly patients undergoing combined spinal-epidural anesthesia

目的分析小剂量右美托咪定在腰硬联合麻醉老年患者髋关节置换术中的应用效果。方法选取2017年10月~2018年10月我院收治的60例老年髋关节置换术患者作为研究对象,采用随机数字表法将其分为对照组和观察组,每组各30例。对照组患者采用腰硬联合麻醉,观察组患者采用腰硬联合麻醉与小剂量右美托咪定静脉滴注麻醉。比较两组患者不同时间点的心率(HR)、血氧饱和度(SpO2)、平均动脉压(MAP)以及麻醉相关不良反应发生情况。结果两组患者术前(T0)的MAP、HR以及SpO2比较,差异无统计学意义(P>0.05);观察组患者给药后(T1)、摆放腰硬联合麻醉体位时(T2)、手术侧卧时(T3)的MAP、HR与SpO2均低于对照组,差异有统计学意义(P<0.05);观察组患者的麻醉相关不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论小剂量右美托咪定在腰硬联合麻醉老年患者髋关节置换术中有显著的应用效果,在今后的临床治疗中,有进一步推广实施的价值。

Objective To analyze the effect of low-dose Dexmedetomidine in hip arthroplasty in elderly patients with combined spinal and epidural anesthesia.Methods Sixty elderly patients undergoing hip arthroplasty admitted in our hospital from October 2017 to October 2018 were selected as research objects.They were divided into control group and observation group according to random number table method,with 30 cases in each group.Patients in the control group received combined lumbar and epidural anesthesia,while patients in the observation group were anesthetized by combined lumbar anesthesia and low-dose Dexmedetomidine intravenous infusion.Heart rate(HR),blood oxygen saturation(SpO2),mean arterial pressure(MAP)at different time points and the anaesthesia-related adverse reactions were compared between the two groups.Results The MAP,HR and SpO2 at preoperative(T0)of the two groups were no statistically significant differences(P>0.05).The MAP,HR and SpO2 of the patients in the observation group were lower than those in the control group,with statistically significant differences(P<0.05),such as after administration(T1),when placing the combined spinal-epidural anesthesia posture(T2),when lying on the side of operation(T3).The total incidence of anesthesia-related adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Low-dose Dexmedetomidine has a significant effect on hip replacement in elderly patients with combined spinal and epidural anesthesia,and it is of further value in the future clinical treatment.