首页|右美托咪定滴鼻结合硬膜外阻滞麻醉对老年髋部骨折患者围术期血流动力学稳定性的影响

右美托咪定滴鼻结合硬膜外阻滞麻醉对老年髋部骨折患者围术期血流动力学稳定性的影响

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目的 分析右美托咪定滴鼻结合髂筋膜硬膜外阻滞麻醉对老年髋部骨折患者围术期血流动力学稳定性的影响.方法 选取 2020 年 2 月至 2023 年 2 月我院收治的 66 例老年髋部骨折围术期患者,随机分为对照组和观察组各33 例.对照组行髂筋膜硬膜外阻滞,观察组行右美托咪定滴鼻结合髂筋膜硬膜外阻滞,对比两组麻醉效果.结果 麻醉时,两组血流动力学指标比较,无显著差异(P>0.05);手术开始时、球囊扩张时、骨水泥注入时、手术结束时,观察组血流动力学SBP、DBP、心率及血氧饱度均优于对照组,差异有统计学意义(P<0.05);术后 12 h、术后 1d、术后 2d时,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);对照组手术时间、排气时间、住院时间、下床活动时间短于观察组,术中出血量均少于观察组,差异有统计学意义(P<0.05).结论 右美托咪定滴鼻结合髂筋膜硬膜外阻滞麻醉用于老年髋部骨折手术麻醉时,安全性高,镇静效果好,提高患者舒适度.
Effect of Intranasal Dexmedetomidine Combined with Epidural Block Anesthesia on Perioperative Hemodynamic Stability in Elderly Patients with Hip Fracture
Objectives To analyze the effect of Intranasal Dexmedetomidine combined with iliac fascia epidural block anesthesia on perioperative hemodynamic stability in elderly patients with hip fracture.Methods A total of 66 elderly patients with perioperative hip fracture admitted to our hospital from February 2020 to February 2023 were randomly divided into control group and observation group,with 33 cases in each group.The control group underwent iliac fascia epidural block anesthesia,while the observation group underwent Intranasal Dexmedetomidine combined with iliac fascia epidural block anesthesia.The anesthetic effects of the two groups were compared.Re-sults During anesthesia,there was no significant difference in hemodynamic indexes between the two groups(P>0.05).The hemodynamic SBP,DBP,heart rate and blood oxygen saturation of the observation group were signifi-cantly better than those of the control group at the beginning of the operation,at the time of balloon dilatation and bone cement injection,and at the end of operation(P<0.05).The VAS scores of the observation group were signifi-cantly lower than those of the control group at 12 h,1d and 2 d after operation(P<0.05).The operation time,exhaust time,hospitalization time and ambulation time of the contro group were significantly shorter than those of the obser-vation group,and the intraoperative blood loss of the contro group was significantly less than that of the observation group(P<0.05).Conclusions Intranasal Dexmedetomidine combined with iliac fascia epidural block anesthesia for elderly hip fracture surgery has high safety and good sedative effect,and can improve patient comfort.

DexmedetomidineNasal dripIliac fascia epidural block anesthesiaHip fracture in the elderly

胡海英

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广信区中医院,江西 上饶 334100

右美托咪定 滴鼻 髂筋膜硬膜外阻滞麻醉 老年髋部骨折

2024

现代诊断与治疗
南昌市医学会 南昌市医学科学研究所

现代诊断与治疗

影响因子:0.736
ISSN:1001-8174
年,卷(期):2024.35(1)
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