右美托咪定复合舒芬太尼对老年髋部骨折术后自控静脉镇痛效果及认知功能影响

Effect of dexmedetomidine combined with sufentanil on postoperative patient-controlled intravenous analgesia and cognitive function in elderly patients with hip fracture

目的研究右美托咪定复合舒芬太尼对老年髋部骨折术后自控静脉镇痛效果及认知功能影响。方法采用随机数表法将收治于2018年1月~2019年12月的120例髋部骨折患者为分为观察组(右美托咪定联合舒芬太尼)与对照组(舒芬太尼),各60例,对比两组患者手术效果、不同时间点的VAS评分、Ramsay评分、术后PCA按压总次数、地佐辛用量、谵妄发生率及术后48 h的不良反应发生率。结果两组患者手术效果无明显差异(P>0.05),观察组不同时间点VAS评分、Ramsay评分显著低于对照组,术后PCA按压总次数、地佐辛用量低于对照组,谵妄发生率及术后48 h的不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定复合舒芬太尼应用于老年髋部骨折术后可有效提升患者自控静脉镇痛效果,降低认知功能障碍,安全性高。

Objective To study the effect of dexmedetomidine combined with sufentanil on postoperative patient-controlled intravenous analgesia and cognitive function in elderly patients with hip fracture.Methods 120 patients with hip fracture admitted to our hospital from January 2018 to December 2019 were selected as clinical research objects.All patients were treated with hip fracture surgery in our hospital,and the age was over 60 years old.120 patients were divided into observation group and control group by random grouping.Each group accounted for 60 cases.Sufentanil was given to the control group,and observation was given dexmedetomidine combined with sufentanil.The effect of operation,VAS score,Ramsay score,total times of PCA compression,dosage of dizosin,incidence of delirium and incidence of adverse reactions 48 hours after operation were compared between the two groups.Results There was no significant difference between the two groups(P>0.05).The VAS score and Ramsay score of the observation group at different time points were significantly lower than those of the control group.The total times of PCA compression and the dosage of dizosin were lower than those of the control group.The incidence of delirium and adverse reactions 48 hours after operation were lower than those of the control group(P<0.05).Conclusion Dexmedetomidine combined with sufentanil can effectively improve the patient-controlled intravenous analgesia effect,eliminate cognitive dysfunction,and have high safety.