右美托咪定在老年患者髋关节置换术中镇静及遗忘效果的临床观察

Clinical observation on sedation and forgetting effect of dexmedetomidine in elderly hip replacement

目的研究及分析小剂量右美托咪定在老年髋关节置换术中镇静及遗忘效果。方法选取2016年3月至2018年9月在我院行髋关节置换手术老年患者240例,将其随机分为四组,每组各60例,患者入室后分别持续泵注右美托咪定、丙泊酚、咪达唑仑及生理盐水,手术结束后,将其镇静及遗忘效果进行对比。结果右美托咪定组、丙泊酚组、咪达唑仑组患者在T1(给药后15 min)、T2(给药后30min)、T3(给药后45 min)、T4(给药60 min)时段镇静效果的评分均优于对照组(P<0.05),差别具有统计学意义,且三组患者术中遗忘率明显高于对照组(P<0.05),差别具有统计学意义,但三组患者之间镇静及遗忘效果比较无显著差异(P>0.05)。结论小剂量右美托咪定应用于老年髋关节置换术患者麻醉,具有丙泊酚及咪达唑仑相同的镇静及遗忘效果,能够有效缓解老年患者围术期恐惧与紧张等不良情绪,值得使用与推广。

Objective To study and analyze the effect of low dose dexmedetomidine on sedation and amnesia in elderly patients undergoing total hip arthroplasty.Methods 240 patients with elderly hip replacement surgery were enrolled in our hospital from March 2016 to September 2018.The patients received continuous infusion of dexmedetomidine,propofol,midazolam and saline respectively.After the surgery,the sedation and amnesia effect of the four groups were compared.Results The scores of sedation effects of dexmedetomidine group,propofol group,and midazolam group at T1(15 min after administration),T2(30 min after administration),T3(45 min after administration),and T4(60 min after administered)were better than the control group(P<0.05),the difference was statistically significant.The amnesia rate of the three groups of patients was significantly higher than the control group(P<0.05),the difference was statistically significant.However,the sedation and amnesia effect with no significant difference among the three groups(P>0.05).Conclusions A small dose of dexmedetomidine anesthesia for elderly patients received hip replacement plays an equal sedative and forgetting effect to propofol and midazolam.It could effectively relieve the perioperative adverse emotions such as fear and anxiety in elderly patients,is worthy of popularization and application.