小剂量右美托咪定在老年下肢手术硬膜外阻滞中的应用

Application of Low-dose Dexmedetomidine in Epidural Anesthesia in Elderly Lower Limb Surgery

目的探究老年下肢手术硬膜外阻滞中小剂量右美托咪定的应用效果。方法方便选取该院2018年1—12月收治的80例老年下肢手术患者为研究对象,所有患者均行下肢骨折内固定术,按照随机数字表法将其分为两组,对照组(n=40)注入局麻药物罗哌卡因,观察组(n=40)硬膜外给予小剂量右美托咪定,对比两组镇静、镇痛效果、不同时间点各项生命体征变化情况。结果观察组Ramsay评分为(3.02±0.28)分,高于对照组,差异有统计学意义(t=17.859,P<0.05),VAS评分为(1.05±0.15)分,低于对照组,差异有统计学意义(t=18.632,P<0.05);与T0时相比,两组均从T1开始SBP、DBP降低,HR减少,但T1~T3时,观察组SBP、DBP均低于对照组,HR小于对照组,波动幅度更小,差异有统计学意义(P<0.05)。结论老年下肢手术硬膜外阻滞中小剂量右美托咪定的镇静、镇痛效果理想,且能有效维持术中各项生命体征稳定。

Objective To explore the effect of low-dose dexmedetomidine in epidural anesthesia in elderly lower limb surgery.Methods convenient selected 80 elderly patients undergoing lower extremity surgery from January to December 2018 in the hospital as the research objects.All patients underwent internal fixation of lower extremity fractures.They were divided into two groups according to a random number table.The control group(n=40)was injected with local anesthetic drugs.Pivacaine,the observation group(n=40)was given a small dose of dexmedetomidine epidurally,and the sedative and analgesic effects and the changes in vital signs at different time points were compared between the two groups.Results The Ramsay score of the observation group was(3.02±0.28)points,which was higher than the control group,the difference was statistically significant(t=17.859,P<0.05),and the VAS score was(1.05±0.15)points,which was lower than the control group,the difference was statistically significant(t=18.632,P<0.05);Compared with T0,SBP and DBP decreased and HR decreased in both groups from T1,but at T1-T3,SBP and DBP of observation group were lower than control group,HR was lower than control group,and the fluctuation range was smaller,the difference was statistically significant(P<0.05).Conclusion The sedative and analgesic effects of low-dose dexmedetomidine in elderly lower limb surgery epidural block are ideal,and it can effectively maintain the stability of various vital signs during surgery.