Comparison of Sedation Effect of Dexmedetomidine and Midazolam under Combined Spinal-epidural Anesthesia on Elderly Patients Undergoing Hip Replacement
Objective:To compare the sedation effect of Dexmedetomidine and Midazolam under combined spinal-epidural anesthesia on elderly patients undergoing hip replacement.Method:The clinical data of 100 elderly patients with hip replacement admitted to Shangrao People's Hospital were retrospectively analyzed from July 2022 to September 2023,they were classified into Midazolam group(31 cases),low-dose Dexmedetomidine group(34 cases)and medium-dose Dexmedetomidine group(35 cases)by different anesthesia methods,the three groups were given combined spinal-epidural anesthesia.The Midazolam group was intravenously injected with 0.05 mg/kg at a rate of 2 mg/min,and the low-dose Dexmedetomidine group and medium-dose Dexmedetomidine group were given intravenous pump loading dose of Dexmedetomidine 0.6 μg/kg within 10 min and was then continuous pump at 0.3 μg/(kg·h)and 0.6 μg/(kg·h).The respiratory rate(RR),blood oxygen saturation(SpO2)and heart rate(HR)before anesthesia,at skin incision,at 10 min after skin incision and at 10 min before the end of surgery and postoperative anesthetic recovery effect(postoperative recovery time,presence or absence of postoperative delirium)were compared,and the incidence rates of adverse anesthesia reactions were statistically analyzed.Result:Before anesthesia,there were no significant differences in RR,SpO2 and HR among the three groups(P>0.05).At skin incision,at 10 min after skin incision and at 10 min before the end of surgery,RR,SpO2 and HR in the three groups were reduced compared with those before anesthesia,the differences were statistically significant(P<0.05);at skin incision,at 10 min after skin incision and at 10 min before the end,there were no statistical differences in SpO2 and HR among the three groups(P>0.05).At skin incision,the RR in Midazolam group and medium-dose Dexmedetomidine group was lower than that in low-dose Dexmedetomidine group(P<0.05);at 10 min after skin incision and at 10 min before the end of surgery,the RR in low-dose Dexmedetomidine group was higher than that in medium-dose Dexmedetomidine group,the differences were statistically significant(P<0.05).The postoperative recovery time in Midazolam group was longer than that of the low-dose Dexmedetomidine group and medium-dose Dexmedetomidine group,and incidence rate of postoperative delirium within 7 days after operation in Midazolam group was higher than that in low-dose dexmedetomidine group and medium-dose Dexmedetomidine group(P<0.05).The total incidence rate of adverse anesthesia reactions in Midazolam group was higher than that in medium-dose Dexmedetomidine group,the difference was statistically significant(P<0.05).Conclusion:In the sedation of elderly patients undergoing hip replacement under combined spinal-epidural anesthesia,both medium-dose Dexmedetomidine and Midazolam have good sedation effect,among which 0.6 μg/(kg·h)Dexmedetomidine has better intraoperative sedation effect,lower incidence rate of intraoperative agitation,lower incidence rate of postoperative delirium and fewer anesthesia adverse reactions.
DexmedetomidineMidazolamCombined spinal-epidural anesthesiaElderly hip replacementSedation
国家科技期刊平台
NSTL
万方数据
