Effects of Different Doses of Remifentanil Combined with Dexmedetomidine on Anesthesia and Hemodynamics in Senile Patients Undergoing Vertebroplasty
Objective:To investigate the effect of different doses of remifentanil combined with dexmedetomidine on anesthesia and hemodynamics in elderly patients undergoing vertebroplasty.Method:A total of 103 elderly patients treated with percutaneous vertebroplasty in Jiangyin Nanzha Hospital from January 2021 to January 2024 were selected as the study objects and divided into two groups according to different doses of remifentanil[group A(n=51)and group B(n=52)].Both groups were injected with 0.3μg/(kg·h)dexmedetomidine by intravenous pump 15 min before surgery and maintained until the end of the operation.5 min before surgery,group A was given 0.5μg/(kg·h)remifentanil intravenously and group B was given 1.0μg/(kg·h)remifentanil intravenously.Hemodynamic indexes,analgesic and sedative effects and adverse reactions were compared between the two groups before anesthesia(T0),during trocar insertion(T1),bone cement injection(T2),skin suture(T3),and 10 min after surgery(T4).Result:At the time point of T0,there was no significant difference in the comparison of mean arterial pressure(MAP),heart rate(HR)and saturation of periphearal oxygen(SpO2)levels between the two groups(P>0.05).The levels of MAP,HR and SpO2 in both groups were lower than those in T0 at each time point from T1 to T4,but the levels of MAP,HR and SpO2 in group B were higher than those in group A at each time point from T1 to T4,with statistical significant differences(P<0.05).From T1 to T3,the RSS scores of group B were higher than those of group A(P<0.05).The visual analogue scales(VAS)scores of group B were lower than those of groupA 1 h,6 h and 12 h after operation,with statistical significant differences(P<0.05).There was no significant difference in comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:1.0μg/(kg·h)remifentanil combined with dexmedetomidine has good analgesic and sedative effects during percutaneous vertebroplasty in elderly patients,and can effectively maintain the hemodynamic stability of patients,without increasing the incidence of adverse reactions,and has good safety.