分析右美托咪定与咪达唑仑椎管内麻醉用于老年下肢骨折手术中的效果

Effect of Dexmedetomidine and Midazolam Intravertebral Anesthesia in the Surgery of Elderly Patients with Lower Extremity Fractures

目的探讨分析应用右美托咪定与咪达唑仑椎管内麻醉对老年下肢骨折手术的作用影响。方法选取2022年5月—2023年5月苏州市相城人民医院实行下肢骨折手术的80例老年患者纳入研究对象,以随机数表法分成两组,每组40例。其中应用咪达唑仑椎管内麻醉的为对照组,应用右美托咪定麻醉的为观察组,比较各项指标。结果干预前两组平均动脉压比较,差异无统计学意义(P>0.05)。在麻醉15、30、60、90 min后,观察组平均动脉压水平波动幅度均小于对照组,差异有统计学意义(P均<0.05)。两组感觉阻滞、运动阻滞的起效时间比较,差异无统计学意义(P均>0.05),观察组维持时间比对照组更长,差异有统计学意义(P<0.05)。术后观察组认知功能评分高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率(7.50%)少于对照组(25.00%),差异有统计学意义(χ^(2)=4.501,P<0.05)。结论相比于咪达唑仑,右美托咪定在老年下肢骨折手术中效果更优,具有较高的稳定性和安全性,且对于老年患者认知功能影响较小。

Objective To investigate the effect of intravertebral anesthesia with dexmedetomidine and midazolam on the operation of lower extremity fracture in elderly patients.Methods A total of eighty elderly patients undergoing lower extremity fracture surgery in Suzhou Xiangcheng People's Hospital from May 2022 to May 2023 were included as the research subjects and divided into two groups by random number table method,with forty cases in each group.Midazolam intravertebral anesthesia was used in control group,dexmedetomidine anesthesia was used in observation group,and all indexes were compared.Results There was no statistically significant difference in mean arterial pres⁃sure at different time points before intervention(P>0.05).At each time point 15 min,30 min,60 min and 90 min after anesthesia,the mean arterial pressure level of the observation group were lower than those of the control group,and the differences were statistically significant(all P<0.05).There was no statistically significant difference in the onset time of sensory block and motor block between the two groups(P>0.05),and the maintenance time of observation group was longer than that of control group,the difference was statistically significant(P<0.05).The cognitive function score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 7.50%,less than that in the control group 25.00%,and the difference was statistically significant(χ^(2)=4.501,P<0.05).Conclusion Compared with midazolam,dexmedetomidine in the surgery of elderly patients with lower extremity fractures cam exerts a more significant effect with higher stability and safety,and has less impact on cognitive function in elderly patients.