摘要
目的评估腰硬麻醉联合盐酸右美托咪定运用于老年髋部骨折手术中的效果。方法方便选取2019年10月—2021年10月于涟水县人民医院行髋部骨折手术的88例老年患者设为研究对象。基于SPSS 25.0软件生成的随机分组序列均分为对照组与观察组,各44例。对照组术中予单一腰硬麻醉,观察组则予腰硬麻醉联合盐酸右美托咪定。评估比对两组手术前后疼痛评分、Ricker镇静评分、血流动力学指标以及不良反应发生情况。结果手术后,观察组视觉模拟疼痛评分(VAS)评分(5.24±0.82)分及Ricker评分(3.02±0.63)分均低于对照组[(6.11±1.03)分,(4.21±0.72)分],差异有统计学意义(t=4.383、8.251,P<0.001);观察组平均动脉压、血氧饱和度及心率均低于对照组,差异有统计学意义(P<0.001);且观察组不良反应发生率(4.55%)低于对照组(20.45%),差异有统计学意义(χ^(2)=5.091,P<0.05)。结论在髋部骨折老年患者手术中运用腰硬联合盐酸右美托咪定麻醉效果理想,其能进一步减少疼痛,提高镇静效果,改善血流动力学指标,降低术后不良反应。
Objective To evaluate the effect of combined spinal and epidural anesthesia combined with dexmedetomidine hydrochloride used in geriatric hip fracture surgery.Methods A sample of 88 elderly patients who underwent hip fracture surgery in Lianshui County People's Hospital from October 2019 to October 2021 was conveniently collected.Based on the random grouping sequence generated by SPSS 25.0 software,they were equally divided into control and observation groups,with 44 cases in each group.The control group was given single combined spinal and epidural anesthesia during surgery,while the observation group was given combined spinal and epidural anesthesia combined with dexmedetomidine hydrochloride.The pain score,Ricker sedation score,hemodynamic indexes and the occurrence of adverse effects were evaluated and compared between the two groups before and after surgery.Results Postoperatively,Visual Analogue Scale(VAS)score(5.24±0.82)points and Ricker score(3.02±0.63)points were lower in the observation group than in the control group[(6.11±1.03)points,(4.21±0.72)points],and the difference was statistically significant(t=4.383,8.251,P<0.001).The mean arterial pressure,oxygen saturation and heart rate in the observation group were lower than those in the control group in all three comparisons,and the difference was statistically significant(P<0.001).And the incidence of adverse reactions in the observation group(4.55%)was lower than that in the control group(20.45%)to a greater extent,and the difference was statistically significant(χ^(2)=5.091,P<0.05).Conclusion The use of combined spinal and epidural anesthesia combined with dexmedetomidine hydrochloride anesthesia in elderly patients with hip fracture is ideal,and it can further reduce pain,improve sedation,improve hemodynamic indexes,and reduce postoperative adverse reactions.
作者
顾顺
查卫峰
王志达
贾银银
GU Shun;ZHA Weifeng;WANG Zhida;JIA Yinyin(Department of Anesthesiology,Lianshui County People's Hospital,Lianshui,Jiangsu Province,223400 China)
出处
《中外医疗》
2023年第14期143-146,共4页
China & Foreign Medical Treatment
关键词
髋部骨折
老年患者
腰硬麻醉
盐酸右美托咪定
VAS疼痛评分
RAMSAY镇静评分
临床指标
不良反应
Hip fracture
Elderly patients
Combined spinal and epidural anesthesia
Dexmedetomidine hydrochloride
VAS pain score
Ramsay sedation score
Clinical indices
Adverse reactions
