摘要
目的探讨右美托咪定对半髋关节置换术老年患者术后苏醒期躁动的影响。方法将80例行半髋关节置换术老年患者随机分为观察组40例和对照组40例,观察组患者从麻醉诱导开始到拔管给予1μg/(kg·h)的右美托咪定泵入,对照组泵入相同剂量生理盐水。术后采用Riker镇静-躁动评分(RSAS)评估两组患者的镇静效果。检测麻醉诱导前(T0)、拔除气管导管即刻(T1)、拔除气管导管后30 min(T2)和术后第1日(T3)的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和C反应蛋白(CRP)的浓度。评估两组患者苏醒期的综合满意度和舒适度。结果观察组出现躁动的比率明显低于对照组(P<0.05)。在T1、T2和T3时,观察组的TNF-α、IL-6和CRP浓度均明显低于对照组(P<0.05)。观察组舒适度为优的比率明显高于对照组(P<0.05)。结论在半髋关节置换术中,右美托咪定可降低老年患者术后苏醒期躁动的发病率和炎症反应程度,同时可有效提高患者的舒适度。
Objective To investigate the dexmedetomidine in prevention of postoperative restlessness in elderly patients with hemiarthroplasty.Methods Eighty elderly patients with hemiarthroplasty were divided into observation group（40 cases）and control group（40 cases）by random number table method.At the beginning of anesthesia induction to extubation time,the observation group was given1μg/kg.h hemiarthroplasty by micro pump,and the control group was given the same dose of physiological saline by micro pump.The sedation effect of the 2 groups was evaluated by Riker sedation agitation score（RSAS）after surgery.The concentration of tumor necrosis factor alpha（TNF-α）and interleukin-6（IL-6）and C reactive protein（CRP）were measured at before anesthesia induction（T0）,removal of tracheal catheter immediately（T1）,removal of the endotracheal tube after 30 min（T2）and first days after surgery（T3）.The overall satisfaction and comfort of the 2 groups were evaluated during stage of analepsia.Results The rate of restlessness in the observation group was significantly lower than that in the control group（P〈0.05）.The concentrations of TNF-α,IL-6 and CRP in the observation group were significantly lower than those in the control group at T1,T2 and T3（P〈0.05）.The rate of comfort degree is excellent in the observation group was higher than that of the control group（P〈0.05）.Conclusions Dexmedetomidine can reduce the incidence of postoperative recovery period restlessness and the degree of inflammatory reaction,and can effectively improve the comfort level of elderly patients with hemiarthroplasty.
作者
莫蝶仪
戴载深
胡洪涛
何永传
钟杰
MO Die-yi;DAI Zai-shen;HU Hong-tao;HE Yong-chuan;ZHONG Jie(Department of Anesthesiology,the Hexian Memorial Hospital of Panyu District,Guangzhou,Panyu 511400 China)
出处
《内蒙古医学杂志》
2018年第7期778-780,共3页
Inner Mongolia Medical Journal
关键词
右美托咪定
髋关节置换
躁动
炎症反应
dexmedetomidine
hip replacement
restlessness
Inflammatory reaction
degree of satisfaction
