右美托咪定联合帕瑞昔布钠超前镇痛对老年关节置换术患者循环系统、麻醉效果及安全性的影响

Effects of dexmedetomidine combined with parecoxib sodium preemptive analgesia on circulatory system, anesthetic effect and safety in elderly patients undergoing joint replacement

目的 探讨右美托咪定联合帕瑞昔布钠超前镇痛对老年关节置换术患者循环系统、麻醉效果及安全性的影响。方法 选取2019年5月至2021年5月我院收治的60例老年关节置换术患者,根据抽签法将其分为对照组和观察组,各30例。对照组采用帕瑞昔布钠超前镇痛,观察组采用右美托咪定联合帕瑞昔布钠超前镇痛。比较两组的镇痛效果。结果 搬送至手术床后(T2)、椎管内麻醉摆放体位后(T3)、麻醉完成后(T4),观察组的心率(HR)、平均动脉压(MAP)低于对照组(P<0.05)。T2、T3、T4时,观察组的视觉模拟评分法(VAS)评分低于对照组,Ramsay镇静评分高于对照组(P<0.05)。两组的不良反应总发生率无显著差异(P>0.05)。结论 右美托咪定联合帕瑞昔布钠超前镇痛在老年关节置换术患者中的效果显著,有助于保持循环系统稳定,且安全性高。

Objective To explore the effects of dexmedetomidine combined with parecoxib sodium preemptive analgesia on circulatory system, anesthetic effect and safety in elderly patients undergoing joint replacement. Methods Sixty elderly patients undergoing joint replacement admitted in our hospital from May 2019 to May 2021 were selected and divided into control group and observation group according to the lottery method, with 30 cases in each group. The control group was treated with parecoxib sodium preemptive analgesia, and the observation group was treated with dexmedetomidine combined with parecoxib sodium preemptive analgesia. The analgesic effects of the two groups were compared. Results After moving to the operation bed(T2), after placing the position of spinal anesthesia(T3), after the completion of anesthesia(T4), the heart rate(HR), mean arterial pressure(MAP) of the observation group were lower than those of the control group(P <0.05). At T2, T3and T4, the Visual Analogue Scale(VAS) score of the observation group was lower than that of the control group, and the Ramsay sedation score was higher than that of the control group(P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion Preemptive analgesia with dexmedetomidine combined with parecoxib sodium has a significant effect in elderly patients undergoing joint replacement, it helps to maintain the stability of the circulatory system, and has high safety.