摘要
目的:探究右美托咪定(Dex)复合椎管内麻醉对老年髋部骨折患者术后定量脑电图与谵妄的影响。方法:将149例行髋部骨折术老年患者按照麻醉方式不同分为对照组(n=74)和观察组(n=75),椎管内麻醉成功后,对照组静脉泵入0.9%氯化钠注射液;观察组静脉泵入Dex。对比两组患者各项临床指标。结果:观察组术后24 h疼痛评分、躁动发生率均低于对照组(P<0.05);术后24 h、48 h,两组患者MMSE评分较术前均升高,且观察组高于对照组(P<0.05)。术后24 h,两组患者各部位的α1波频率较术前均下降,但观察组高于对照组;各部位δ波频率均升高,但观察组低于对照组(P<0.05);观察组术后谵妄发生率低于对照组(P<0.05);两组不良反应总发生率无统计学差异(P>0.05)。结论:老年髋部骨折患者应用Dex复合椎管内麻醉,可减轻对定量脑电图的影响,降低术后谵妄、躁动发生率,且安全性良好。
Objective:To explore the effect of dexmedetomidine(Dex)combined with intraspinal anesthesia on postoperative quantitative electroencephalogram and delirium in elderly patients with hip fracture.Methods:A total of 149 elderly patients undergoing hip fracture surgery were divided into control group(n=74)and observation group(n=75)according to different anesthesia methods.After successful implementation of intraspinal anesthesia,the control group was given intravenous injection of 0.9%sodium chloride,while the observation group was given intravenous injection of Dex.Clinical indexes were compared between the two groups of patients.Results:The pain score and the incidence of agitation in observation group at 24 h after operation were lower than those in control group(P<0.05).At 24 and 48 h after surgery,the MMSE scores of both groups of patients increased compared to before surgery,and the observation group was higher than the control group(P<0.05).Theα1 wave frequency decreased andδwave frequency increased in the two groups at 24 h after operation.α1 wave frequency in observation group was higher andδwave frequency was lower than that in control group(P<0.05).The incidence of postoperative delirium in observation group was lower than that in control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dex combined with intraspinal anesthesia can reduce the influence on quantitative electroencephalogram and the incidence of postoperative delirium and agitation in elderly patients undergoing hip fracture surgery,with good safety.
作者
袁溪
兰启琴
吴雯
刘飞
陈史伟
YUAN Xi;LAN Qi-qin;WU Wen;LIU Fei;CHEN Shi-wei(Department of Anaesthesiology,Xichang People s Hospital,Affiliated Hospital of Xichang College,Xichang 615000,Sichuan,China)
出处
《川北医学院学报》
CAS
2024年第6期795-798,共4页
Journal of North Sichuan Medical College
基金
医学科研发展基金项目临床与基础研究专项(S031)。
关键词
老年
髋部骨折术
右美托咪定
椎管内麻醉
定量脑电图
谵妄
Elderly
Hip fracture surgery
Dexmedetomidine
Intraspinal anesthesia
Quantitative electroencephalogram
Delirium
