右美托咪定对老年关节置换患者术后谵妄及不良反应的预防作用

Preventive Effects of Dexmedetomidine on Postoperative Delirium and Adverse Reactions in Elderly Patients Undergoing Joint Replacement

目的:探究右美托咪定对老年关节置换患者术后谵妄的防治作用。方法:选取2018年1月—2023年6月于苏州永鼎医院接受关节置换术治疗的60例患者,将其随机分成试验组及对照组,各30例。两组患者均开展腰硬联合麻醉,在开展腰硬联合麻醉之前及术中,试验组泵注右美托咪定,对照组泵注等量0.9%氯化钠溶液。比较两组不同时间点血流动力学指标(心率、平均动脉压)、术后谵妄及不良反应发生情况。结果:对照组手术开始5 min和30 min的心率和平均动脉压均高于术前,差异有统计学意义(P<0.05);试验组手术开始5 min和30 min的心率和平均动脉压均低于对照组,差异有统计学意义(P<0.05)。试验组谵妄、不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论:右美托咪定应用于老年患者的关节置换手术中,有助于稳定血流动力学,减少术后谵妄及术后不良反应发生率。

Objective:To investigate the preventive and therapeutic effects of Dexmedetomidine on postoperative delirium in elderly joint replacement patients.Method:Sixty patients who received joint replacement treatment in Suzhou Yongding Hospital from January 2018 to June 2023 were selected,and they were randomly divided into experimental group and control group,with 30 patients in each group.Both groups underwent combined epidural anesthesia.Before combined epidural anesthesia and during surgery,the experimental group was injected with Dexmedetomidine and the control group was injected with 0.9%Sodium Chloride Injection.Hemodynamic indexes(heart rate,mean arterial pressure)at different time points,postoperative delirium and adverse reactions were compared between the two groups.Result:The heart rate and mean arterial pressure of the control group at 5 min and 30 min at the beginning of operation were higher than those before operation,and the differences were statistically significant(P<0.05).The heart rate and mean arterial pressure of the experimental group were lower than those of the control group at 5 min and 30 min after operation,and the differences were statistically significant(P<0.05).The total incidence of delirium and adverse reactions in experimental group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion:Dexmedetomidine is helpful to stabilize hemodynamics and reduce postoperative delirium and adverse reactions in elderly patients undergoing joint replacement surgery.