右美托咪定复合亚麻醉剂量艾司氯胺酮对老年经皮椎体成形术患者镇痛镇静效果的影响

Effect of Dexmedetomidine Combined with Subanesthetic Dose Esketamine Hydrochloride on Analgesia and Sedative Effects in Elderly Patients Undergoing Percutaneous Vertebroplasty

目的:探讨右美托咪定复合亚麻醉剂量艾司氯胺酮对老年经皮椎体成形术患者镇痛镇静效果的影响。方法:选取2020年2月—2022年2月萍乡市第二人民医院收治的102例老年经皮椎体成形术患者为研究对象,用随机数字表法分为常规组(n=51,舒芬太尼+右美托咪定)、观察组(n=51,右美托咪定+亚麻醉剂量艾司氯胺酮)。比较两组血流动力学指标[心率、平均动脉压(MAP)、中心静脉压(CVP)]、术后疼痛情况、躁动发生情况及不良反应。结果:麻醉诱导时(T1)和术后2 min(T2)时观察组MAP、心率、CVP均低于常规组,差异均有统计学意义(P<0.05)。观察组躁动程度低于常规组,差异有统计学意义(P<0.05)。观察组术后9、18、36 h Prince-Henry评分均低于常规组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定复合亚麻醉剂量艾司氯胺酮用于老年经皮椎体成形术可稳定术中血流动力学,有利于降低患者躁动发生风险,减轻术后疼痛,且安全性较好。

Objective:To investigate the effect of Dexmedetomidine combined with subanesthetic dose Esketamine Hydrochloride on analgesia and sedative effects in elderly patients undergoing percutaneous vertebroplasty.Method:A total of 102 elderly patients underwent percutaneous vertebroplasty admitted to Pingxiang NO.2 People's Hospital from February 2020 to February 2022 were selected as the study objects,and were divided into conventional group(n=51,Sufentanil+Dexmedetomidine)and observation group(n=51,Dexmedetomidine+subanesthetic dose Esketamine Hydrochloride)according to random number table method.Hemodynamics indexes[heart rate,mean arterial pressure(MAP),central venous pressure(CVP)],postoperative pain situation,incidence of restlessness and adverse reactions were compared between the two groups.Result:Induction of anesthesia(T1)and 2 min after operation(T2),MAP,heart rate and CVP of observation group were lower than those of conventional group,the differences were statistically significant(P<0.05).The restlessness degree of the observation group was lower than that of the conventional group,the difference was statistically significant(P<0.05).The Prince-Henry scores of the observation group at 9,18 and 36 h after operation were lower than those of the conventional group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dexmedetomidine combined with subanesthetic dose Esketamine Hydrochloride in elderly patients undergoing percutaneous vertebroplasty can stabilize intraoperative hemodynamics,which is conducive to reducing the risk of restlessness,alleviating postoperative pain,and has good safety.