右美托咪定用于老年患者经尿道前列腺电切术椎管内麻醉的效果分析

Analysis of the Effect of Dexmedetomidine in Intraspinal Anesthesia for Transurethral Resection of the Prostate in Elderly Patients

目的分析在老年患者接受经尿道前列腺电切术的椎管内麻醉中应用右美托咪定的作用。方法方便选取2017年3月—2019年6月96例老年前列腺增生患者为对象,按照入院顺序分为对照组48例在椎管内麻醉中应用氯化钠溶液,观察组48例在椎管内麻醉中应用右美托咪定,比较两组体征水平、术后早期认知功能、不良反应发生率。结果观察组T2到T4的心率及平均动脉压均低于T1;对照组T2、T3的心率及平均动脉压均低于T1、T4,但观察组两组数据总体均明显低于对照组,各项结果差异均有统计学意义(P<0.05);观察组术后3 d内认知功能障碍发生率为4.17%,低于对照组发生率16.67%(χ^(2)=4.019,P<0.05);观察组用药后不良反应发生率为8.33%,低于对照组不良反应发生率22.92%(χ^(2)=3.872,P<0.05)。结论对接受经尿道前列腺电切术治疗的老年前列腺增生患者实施椎管内麻醉中应用右美托咪定,可减轻体征水平波动,减轻对术后早期认知功能的影响,减少不良反应发生率。

Objective To analyze the effect of dexmedetomidine in the spinal anesthesia of elderly patients undergoing transurethral resection of the prostate.Methods Convenient to select 96 elderly patients with benign prostatic hyperplasia from March 2017 to June 2019 were divided into the control group of 48 cases in the control group were treated with sodium chloride solution during spinal anesthesia,and 48 cases in the observation group were treated with dexmedetomidine during spinal anesthesia;to compare the levels of physical signs,early postoperative cognitive function,and incidence of adverse reactions between the two groups.Results The heart rate and average arterial pressure of the observation group from T2 to T4 were lower than T1;the heart rate and average arterial pressure of T2 and T3 of the control group were lower than T1 and T4,but the overall data of the observation group were significantly lower than those of the control group.The differences in the results were statistically significant(P<0.05);the incidence of cognitive dysfunction in the observation group within 3 days after surgery was 4.17%,which was lower than the incidence of 16.67%in the control group(χ^(2)=4.019,P<0.05);The incidence of adverse reactions in the group was 8.33%,which was lower than the incidence of 22.92%in the control group(χ^(2)=3.872,P<0.05).Conclusion Applying dexmedetomidine during intraspinal anesthesia to elderly patients with prostate hyperplasia undergoing transurethral resection of prostate can reduce the fluctuation of physical signs,reduce the impact on early postoperative cognitive function,and reduce the occurrence of adverse reactions rate.