右美托咪定联合腰硬联合麻醉在老年骨科手术患者中的应用效果

Application effect of dexmedetomidine combined with combined spinal-epidural anesthesia in elderly patients undergoing orthopedic surgery

目的 探讨右美托咪定(DEX)联合腰硬联合麻醉(CSEA)在老年骨科手术患者中的应用效果。方法 选取我院2019年1月至2021年1月收治的200例下肢骨折患者为研究对象,随机将其分为对照组和观察组,各100例。对照组采用CSEA,观察组采用CSEA+DEX。比较两组的麻醉效果。结果 观察组的麻醉总有效率高于对照组(P<0.05)。麻醉30 min、术后2 h,观察组的疼痛数字评价量表(NRS)、Richmond躁动-镇静量表(RASS)评分低于对照组(P<0.05)。术后24 h,观察组的一氧化氮(NO)、β-内啡肽(β-EP)、P物质(SP)水平低于对照组(P<0.05)。术后2 h,观察组的收缩压(SBP)、舒张压(DBP)、心率(HR)低于对照组(P<0.05)。结论 DEX联合CSEA在老年骨科手术患者中的应用效果突出,能有效缓解术后疼痛,稳定血流动力学指标,有利于患者术后恢复。

Objective To investigate the application of dexmedetomidine(DEX)combined with combimed spinal-epidural anesthesia(CSEA)in elderly patients undergoing orthopedic surgery.Methods A total of 200 patients with lower limb fracture admitted in our hospital from January 2019 to January 2021 were selected as the study objects and randomly divided into control group and observation group,with 100 cases in each group.The control group used CSEA,while the observation group used CSEA+DEX.The anesthetic effects of the two groups were compared.Results The total effective rate of anesthesia in the observation group was higher than that in the control group(P<0.05).At 30 min of anesthesia and 2 h after surgery,Numerical Rating Scale(NRS)and Richmond Agitation-Sedation Scale(RASS)scores in the observation group were lower than those in the control group(P<0.05).At 24 h after surgery,the levels of nitric oxide(NO),β-endorphin(β-EP)and substance P(SP)in the observation group were lower than those in the control group(P<0.05).At 2 h after surgery,systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)in the observation group were lower than those in the control group(P<0.05).Conclusion DEX combined with CSEA has an outstanding effect on elderly patients undergoing orthopedic surgery,it can effectively relieve postoperative pain and stabilize hemodynamics indexes,which is conducive to postoperative recovery of patients.