Clinical Efficacy of Dexmedetomidine Combined with Ropivacaine Assisted Brachial Plexus Block Anesthesia in Elderly Fractures
Objective:To observe the effect of dexmedetomidine combined with ropivacaine on brachial plexus block anesthesia in elderly patients undergoing orthopaedic surgery and its influence on vital signs.Methods:126 elderly fracture patients who were operated on in the hospital from March 2020 to May 2022 were taken as the research object.They were divided into a combined group and a control group according to the ratio of 1:1 by drawing lots.There were 63 patients in each group.During the operation,ropivacaine was injected into the brachial plexus for block anesthesia.On this basis,dexmedetomidine was used as an auxiliary anesthesia to compare the analgesic effects of the two groups during and after the operation,postoperative signs and adverse events.Results:There was no significant difference in MAP and HR between the two groups before anesthesia(T0)(P＞0.05).MAP at 10 min(T1),30 min(T2)and at the end of operation(T3)in the combined group were(76.32±0.31)mmHg,(75.35±0.22)mmHg,(74.12±0.33)mmHg,respectively,which were lower than those in the control group(76.65±0.88)mmHg,(75.62±0.81)mmHg,(74.45±0.83)mmHg,with statistically significant differences(t=2.807,2.553,2.933;P＜0.05).HR was(65.34±0.11)times/min,(64.21±0.25)times/min,(63.11±0.13)times/min,respectively,which were lower than that of the control group(65.66±0.85)times/min,(64.57±0.82)times/min,(63.46±0.81)times/min,with statistically significant difference(t=2.963,3.333,3.203;P＜0.05).The VAS scores of 30 min,1 h,3 h and 5 h after operation were(4.42±0.31)(3.77±0.25)(3.14±0.25)and(2.26±0.37),respectively,which were lower than those of the control group(4.71±0.83)(4.04±0.82)(3.52±0.85)and(2.61±0.81)(t=2.598,2.500,3.404,3.120;P＜0.05).The number of PCA compression was(10.11±0.24)times/24 h,which was lower than(10.48±0.88)times/24 h of the control group,with statistically significant difference(t=3.220,P＜0.05).The stopping time(40.25±0.31)h was lower than that of the control group(40.61±0.83)h,and the difference was statistically significant(t=3.225,P＜0.05).SBP was(125.11±10.32)mmHg after awakening,which was significantly lower than(130.45±10.28)mmHg of the control group(t=2.910,P＜0.05).DBP was(85.44±1.36)mmHg,which was lower than(86.26±1.45)mmHg of control group,with statistically significant difference(t=3.274,P＜0.05).HR was(105.44±5.25)times/min was lower than that(108.42±5.31)times/min in the control group(t=3.168,P＜0.05).The incidence of side effects of anesthetic drugs and postoperative complications was 7.94％,which was slightly higher than 6.35％in the control group(x2=0.191,P＞0.05).Conclusion:The combined application of dexmedetomidine assisted ropivacaine brachial plexus block anesthesia during the operation of elderly fracture patients can significantly enhance the analgesic effect during and after the operation,and has a positive role in maintaining the stability of the patient's physical signs after awakening.Moreover,this anesthesia method does not significantly enhance the risk of adverse events such as side effects and postoperative complications,and it is safe.
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