摘要
目的探讨右美托咪定对老年患者全髋关节置换术后早期睡眠质量的影响。方法择期在蛛网膜下腔阻滞下行全髋关节置换手术的老年患者40例,ASA分级Ⅱ～Ⅲ级,随机分为两组(n=20),右美托咪定组患者予右美托咪定0.5μg/kg,持续泵注10 min后,以0.2μg/(kg·h)持续泵注至手术结束;对照组泵注等体积的生理盐水。连续监测患者术日晚20:00～术后第2天8:00期间的脑电双频指数(BIS)得出总睡眠时间和觉醒时间;并每隔2 h记录平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO_2)和呼吸频率(RR);记录术后第2天8:00时患者的PSQI量表评分。结果两组患者术日晚20:00～术后第2天8:00间,对照组与右美托咪定组每隔2 h的MAP、HR、SpO_2及RR比较,差异均无统计学意义(P>0.05);与对照组相比较,右美托咪定组患者总睡眠时间显著延长,PSQI值明显降低,且均值小于7分,差异有统计学意义(P<0.05)。结论右美托咪定应用于择期在蛛网膜下腔阻滞下行全髋关节置换术的老年患者,能提高患者术后早期睡眠质量,值得临床推广应用。
Objective To investigate the effect of dexmedetomidine on the early sleep quality in elderly patients after total hip arthroplasty.Methods 40 cases of elderly patients undergoing selective total hip arthroplasty under subarachnoid block,with ASA gradeⅡ-Ⅲ,were randomly divided into two groups(n=20).Patients in the dexmedetomidine group were given dexmedetomidine of 0.5μg/kg.After continuous pump of 10 min,0.2μg/(kg·h)was kept for continuous pump until the end of surgery;the control group was pumped with equal volumes of normal saline.The EEG bispectral index(BIS)was continuously monitored on the day of surgery from 20:00 pm to 8:00 am on the second day of surgery,and the total sleep time and waking time were obtained;mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO2)and respiratory rate(RR)were recorded at the interval of every 2 hours.The patient's PSQI score was recorded at 8:00 am on the second day after surgery.Results There were no statistically significant differences in MAP,HR,SpO2 and RR between the control group and the dexmedetomidine group at the interval of every 2 hours between 20:00 and 8:00 on the second day after surgery(P>0.05);compared with the control group,the total sleep time in the patients in the dexmedetomidine group was significantly longer,PSQI value was decreased significantly,and the mean value was less than 7 points.The differences were statistically significant(P<0.05).Conclusion Dexmedetomidine can be used in elderly patients undergoing selective total hip arthroplasty under subarachnoid block to improve early postoperative sleep quality,which is worthy of clinical promotion and application.
作者
房君
王瑞春
郑晋伟
FANG Jun;WANG Ruichun;ZHENG Jinwei(ICU,Ningbo Second Hospital,Ningbo 315010,China;Department of Anesthesiology,Ningbo Second Hospital,Ningbo 315010,China)
出处
《中国现代医生》
2018年第7期93-96,共4页
China Modern Doctor
基金
浙江省医药卫生科技项目(2014KYB232
2018KY693)
浙江省宁波市科技惠民项目(2017C50060)
浙江省宁波市自然科学基金(2016A610144)
