右美托咪定复合七氟醚麻醉对老年下肢骨折患者术后结局的影响

Effects of Dexmedetomidine Combined with Sevoflurane Anesthesia on Postoperative Outcomes in Elderly Patients with Lower Extremity Fracture

目的探究老年下肢骨折患者应用右美托咪定复合七氟醚麻醉后的术后结局改善情况。方法筛选2019年1月—2021年6月于聊城市中医医院治疗的71例老年下肢骨折患者作为研究对象,随机均分为观察组(n=35)与对照组(n=36),前者应用七氟醚、右美托咪定两种麻醉药物复合麻醉,后者应用右美托咪定、丙泊酚两种麻醉药物复合麻醉。比较两组患者术后短期认知功能、不同时刻应激反应指标、术后疼痛情况。结果观察组术后2、4、8 h的MMSE评分分别为(17.77±3.08)分、(22.14±2.43)分、(26.00±1.33)分均高于对照组,差异有统计学意义(t=6.220、7.319、9.398,P<0.001)。观察组与对照组相比,T1~T4时刻NE、Glu及Cor水平以及术后2、4、8 h及12 hVAS评分均较低,差异有统计学意义(P<0.05)。结论右美托咪定复合七氟醚能改善老年下肢骨折患者术后认知功能,调节患者应激指标水平,同时改善术后疼痛情况。

Objective To explore the improvement of postoperative outcomes in elderly patients with lower extremity fracture after anesthesia with Dexmedetomidine combined with Sevoflurane.Methods 71 elderly patients with lower extremity fracture treated in Liaocheng Hospital of Traditional Chinese Medicine from January 2019 to June 2021 were selected as the study subjects and randomly divided into observation group(n=35)and control group(n=36).The former was combined with Sevoflurane and Dexmedetomidine,while the latter was combined with Dexmedetomidine and Propofol.Compared short-term cognitive function,stress response indicators at different times,and postoperative pain between two groups of patients.Results The MMSE scores of the observation group were(17.77±3.08)points and(22.14±2.43)points and(26.00±1.33)points respectively at 2 h,4 h and 8 h after surgery,and the difference were statistically significant(t=6.220,7.319,9.398,P<0.001).Compared with the control group,NE,Glu and Cor levels at T1 to T4 and VAS scores at 2 h,4 h,8 h and 12 h after surgery in the observation group were lower,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with Sevoflurane can improve postoperative cognitive function,regulate the level of stress indicators,and improve postoperative pain in elderly patients with lower extremity fracture.