Perioperative effects of dexmedetomidine combined with ropivacaine SAPB on elderly patients with thoracic disc herniation undergoing vertebral body fusion surgery
Objective To explore the clinical efficacy of dextrometomidine intravenous drip combined with Ropivacaine single plane block of Serratus anterior muscle(SAPB)in elderly patients with thoracic disc herni-ation(TDH)undergoing vertebral body fusion surgery and postoperative serum CRP,cTnI,S100β.Methods One hundred and twenty-two TDH patients who underwent vertebral body fusion surgery in Shijiazhuang Hospital of Traditional Chinese Medicine from January 2019 to December 2022 were selected as subjects.The patients were randomly divided into two groups:the ropivacaine SAPB group(R/SAPB group)and the dexmedetomidine intravenous infusion combined with ropivacaine SAPB group(Dex+R/SAPB group).We collected basic clinical information,perioperative information,visual analgesia simulation scove(VAS)and postoperative adverse reactions in preoperative(T0),postoperative 24h(T1)and postoperative 72h(T2)peri-ods.and incidence of postoperative adverse reactions for two groups of patients.ELISA detection of preopera-tive and postoperative serum CRP,cTnI,S100β Horizontal.Results There was little difference in basic clini-cal information between the two groups of patients(P＞0.05).Compared with R/SAPB group,Dex+R/SAPB group had a decrease in the time to remove tracheal catheters,the proportion of delayed awakening,and the proportion of restless patients during the awakening period,while maintaining analgesia time was prolonged(P＜0.05).Compared with R/SAPB group,Dex+R/SAPB group showed a decrease in VAS scores at T1 and T2(P＜0.05).The probability of adverse reactions in Dex+R/SAPB group was lower than that in R/SAPB group(P＜0.05).There was no significant difference in the levels of serum factors CRP,cTnI and S100β between the two groups at time T0 before operation(P＞0.05).At T2 after operation,the levels of serum CRP,cTnI and S100β increased in both groups(P＜0.05).At T2,compared with R/SABB group,the levels of serum CRP,cTnI and S100β in Dex+R/SABB group decreased(P＜0.05).At T2,compared with R/SAPB group,the levels of serum CRP,cTnI and S100β in patients with postoperative ad-verse reactions were significantly higher(P＜0.05).Conclusion Ropivacaine combined with Dex intravenous drip can reduce postoperative inflammatory reaction,myocardial injury and cognitive impairment in patients with TDH,improve perioperative quality and reduce the incidence of postoperative adverse reactions.
Thoracic disc herniationVertebral bone graft fusion surgeryPlane block of inferior Ser-ratus anterior muscleDexmetomidinePostoperative analgesiaSerum factor
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