摘要
目的探讨辅助应用右美托咪定对老年下肢骨折全身麻醉患者苏醒期躁动及机体应激反应的影响。方法选取2021年6—12月广州市中西医结合医院收治的50例老年下肢骨折全身麻醉患者作为研究对象,依据麻醉药物的不同分为A组与B组,每组25例。A组麻醉诱导前给予右美托咪定,B组麻醉诱导前给予氯化钠溶液,比较两组自主呼吸恢复时间、睁眼时间、苏醒期躁动反应、机体应激反应及并发症发生情况。结果两组自主呼吸恢复时间、睁眼时间比较差异无统计学意义。A组拔管时、拔管后5 min苏醒期躁动反应Riker镇静与躁动(RSAS)评分均低于B组,差异有统计学意义(P<0.05)。术前、用药后30min,两组去甲肾上腺素(NE)、肾上腺素(E)及皮质醇(Cor)水平比较差异无统计学意义;用药后60min、术毕,A组NE、E、Cor水平均低于B组,差异均有统计学意义(P<0.05)。A组寒战发生率低于B组,差异有统计学意义(P<0.05);两组低氧血症、导管脱出发生率比较差异无统计学意义。结论右美托咪定能有效改善老年下肢骨折全身麻醉患者苏醒期躁动及机体应激反应,减少并发症发生。
Objective To investigate the effects of adjuvant use of dexmedetomidine on restlessness and body stress response during recovery elderly patients with lower limb fracture under general anesthesia.Methods 50 elderly patients with lower limb fracture under general anesthesia admitted to Guangzhou Hospital of Integrated Chinese and Western Medicine from June to December 2021 were selected as the study subjects,and they were divided into the group A and the group B according to the different drugs in anesthesia,with 25 cases in each group.Group A was given dex-medetomidine before anesthesia induction and group B was given sodium chloride solution before anesthesia induction.The recovery time of spontane-ous respiration,eye opening time,agitation reaction,body stress reaction and complications were compared between the two groups.Results There were no significant differences in recovery time of spontaneous respiration and eye opening time between the two groups.The scores of Riker sedation and agitation(RSAS)during extubation and 5 min after extubation in the group A were lower than those in the group B,and the difference was statisti-cally significant(P<0.05).There were no significant differences in the levels of norepinephrine(NE),epinephrine(E)and cortisol(Cor)between the two groups before and 30 min after treatment;60 min after treatment and after operation,the levels of NE,E and Cor in the group A were lower than those in the group B,and the differences were statistically significant(P<0.05).The incidence of chasm in the group A was lower than that in the group B,and the difference was statistically significant(P<0.05);there were no statistically significant differences in the incidence of hypoxemia and catheter withdrawal between the two groups.Conclusion Dexmedetomidine can effectively improve agitation and body stress response during recov-ery period in elderly patients with lower limb fracture under general anesthesia,and reduce the incidence of complications.
作者
韦坚志
蒋思文
WEI Jianzhi;JIANG Siwen(Department of Anesthesiology,Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Guangzhou,Guangdong,510800,China)
出处
《当代医学》
2024年第1期94-98,共5页
Contemporary Medicine
关键词
下肢骨折
老年患者
右美托咪定
苏醒期躁动
机体应激反应
并发症
Lower limb fracture
Elderly patients
Dexmedetomidine
Agitation during awakening
Body stress response
Complication
