首页|瑞芬太尼结合右美托咪定对年龄≥60岁膝关节置换术患者术中控制性降压效果研究

瑞芬太尼结合右美托咪定对年龄≥60岁膝关节置换术患者术中控制性降压效果研究

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目的 研究瑞芬太尼结合右美托咪定对年龄≥60岁膝关节置换术患者术中控制性降压效果的影响.方法 采用均衡、随机化原则将2021年3月至2023年2月在阜南县人民医院接受膝关节置换术治疗的104例年龄≥60岁患者划分为对照组和试验组,每组52例.术中对照组采用单一右美托咪定降压方案,而试验组采用瑞芬太尼结合右美托咪定降压方案,对比2组术中不同时间段(麻醉前、插管前、插管后、术中10 min、术中30 min、停止药3 min)的血压(收缩压、舒张压)、心率;同时,对比2组患者达到控制性降压目标时间、麻醉恢复质量.结果 在插管前、插管后、术中10 min、术中30 min时刻,试验组的收缩压、舒张压、心率均低于对照组(P<0.05);试验组达到控制性降压目标时间短于对照组,其麻醉恢复质量评分高于对照组(P<0.05).结论 在年龄≥60岁膝关节置换术患者中采用瑞芬太尼结合右美托咪定,能提高控制性降压效果和麻醉恢复质量.
Effect of remifentanil combined with dexmedetomidine on intraoperative controlled hypotension in patients aged more than 60 years undergoing total knee arthroplasty
Objective To study the effect of remifentanil combined with dexmedetomidine on intraoperative controlled hypotension in patients aged more than 60 years undergoing total knee arthroplasty(TKA).Methods This was a parallel,randomized study involving 104 patients aged more than 60 years who received TKA in Funan county people's hospital from March 2021 to February 2023,they were assigned into control group(n=52)and experimental group(n=52).All patients were managed by dexmedetomidine during operation,and those in experimental group were additionally given remifentanil.The systolic blood pressure(SBP)and diastolic blood pressure(DBP),and heart rate at different intraoperative time periods(before anesthesia,before and after intubation,10 min intraoperatively,30 min intraoperatively,3 min after discontinuation),the time to achieve the controlled hypotensive target,and the quality of anesthesia recovery between groups were compared.Results Before and after intubation,and at 10 min and 30 min intraoperatively,the experimental group had significantly lower SBP,DBP and heart rate,shorter the time to achieve the controlled hypotensive target,higher quality of anesthesia recovery than the control group(all P<0.05).Conclusion The combination of remifentanil and dexmedetomidine can improve the effect of controlled hypotension and the quality of anesthesia recovery in patients aged more than 60 years undergoing TKA.

total knee arthroplastyaged more than 60 yearsremifentanildexmedetomidinecontrolled hypotension

李孝峰、童尧、张繁、方秀春

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236300 安徽省阜南县人民医院麻醉科

上海交通大学医学院附属瑞金医院麻醉科

膝关节置换术 年龄≥60岁 瑞芬太尼 右美托咪定 控制性降压

上海市科学技术委员会扬帆计划

19YF1430700

2024

河北医药
河北省医学情报研究所

河北医药

CSTPCD
影响因子:1.075
ISSN:1002-7386
年,卷(期):2024.46(18)
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