右美托咪定和依托咪酯在膝关节置换术中的效果

Effects of Dexmedetomidine and Etomidate During Knee Arthroplasty

目的浅析右美托咪定和依托咪酯在老年患者膝关节置换手术中行监护性麻醉的效果和安全性观察。方法纳入本单位于2018年1月—2020年3月收治的老年行膝关节置换手术患者60例作研究样本,按照麻醉方法不同划分为观察组与对照组各30例,观察组应用右美托咪定和依托咪酯麻醉法,对照组单独应用右美托咪定麻醉,比较两组患者血氧饱和度(oxygen saturation,SpO2)、心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)水平、呼吸恢复、可唤醒时间、拔管时间、不良反应发生率。结果两组患者T1、T3时HR、MAP、SpO2指标值比较差异无统计学意义,P>0.05;但观察组在T2时HR、MAP、SpO2值均高于对照组,P<0.05。观察组患者呼吸恢复、可唤醒时间、拔管时间与对照组比较差异无统计学意义,P>0.05。观察组不良反应发生率10.00%,低于对照组33.33%,差异具有统计学意义(P<0.05)。结论老年患者膝关节置换手术中联合应用右美托咪定和依托咪酯麻醉方案可确保术中体征平稳,麻醉效果好,苏醒质量高,降低不良反应风险。

Objective To analyze the monitored anesthesia care effects and safety with dexmedetomidine and etomidate during knee arthroplasty.Methods 60 elderly patients of undergoing knee arthroplasty from January 2018 to March 2020 in our hospital were chosen as research samples.According to different anesthesia modes,patients were divided into observation group(30 cases)and control group(30 cases).The observation group took dexmedetomidine and etomidate;the control group just took dexmedetomidine.SpO2(oxygen saturation),HR(heart rate),MAP(mean arterial pressure),respiratory recovery,awakening and extubation time as well as adverse event rate were compared.Results At T1 and T3,HR,MAP and SpO2 values between groups showed no statistically significant difference(P>0.05);at T2,HR,MAP and SpO2 in the observation group were higher than control group(P<0.05);respiratory recovery,awakening and extubation time between groups showed no statistically significant difference(P>0.05);adverse event rate in the observation group(10.00%)was lower than control group(33.33%),with statistically significant difference(P<0.05).Conclusion During knee arthroplasty,the combined schemes of dexmedetomidine and etomidate can stabilize the clinical signs,increase the anesthesia effects,improve the awakening conditions and reduce the adverse reactions.