右美托咪定复合丙泊酚全麻对老年骨科患者术中应激反应及术后谵妄的影响

Effect of General Anesthesia by Dexmedetomidine Combined with Propofol on Stress Response During Orthopaedic Surgery and Postoperative Delirium in the Aged

目的 :分析右美托咪定复合丙泊酚全麻对老年骨科患者术中应激反应及术后谵妄的影响。方法 :选择我院骨科2015年8月-2016年8月收治的需行手术治疗的老年患者122例,随机分为常规组与实验组,各61例。常规组与实验组分别采取丙泊酚+芬太尼与右美托咪定复合丙泊酚麻醉。结果 :实验组镇静评分、丙泊酚剂量、麻醉起效与阻滞完善时间相比常规组均明显较优(P<0.05);实验组与常规组术后谵妄发生率分别为4.92%与21.31%(P<0.05);实验组术后生活质量评分相比常规组明显较优(P<0.05)。结论 :对老年骨科手术治疗患者采取右美托咪定复合丙泊酚全麻的应用效果显著,具有麻醉见效快、术后并发症少等优势,可明显改善患者生活质量,值得实践推广。

Objective:To analyze the effect of general anesthesia by dexmedetomidine combined with propofol on stress response during orthopaedic surgery and postoperative delirium in the aged. Methods:A total of 122 aged patients with indications of orthopaedic surgery in department of orthopaedics, Hospital of Anyang Region, Henan Province from August 2015 to August 2016 were randomly divided into control and trial groups, 61 for each, and anaesthetized by propofol plus fentanyl and propofol plus dexmedetomidine respectively. Results:The score for calmness, dosage of propofol as well as times for onset of anesthesia and maximum sensory block in trial group were superior to those in control group(P<0.05). The incidence rates of postoperative delirium in trial and control groups were 4.92% and 21.31% respectively(P<0. 05). However, the scores for life quality of patients in trial group were significantly higher than those in control group(P<0.05). Conclusion:The time for onset of general anesthesia by dexmedetomidine combined with propofol in aged patients receiving orthopaedic surgery was shortened, while the postoperative complications decreased, which improved the life quality of patients and was worthy of popularization.