[1]谭国政　李　锋　赖丽娜.老年患者膝关节镜手术腰麻联合硬膜外麻醉中应用盐酸右美托咪定的镇痛镇静效果及对手术应激的影响[J].大众科技,2020,22(10):61-63.
　Analgesic and Sedative Effect of Dexmedetomidine Hydrochloride in Combined Spinal and Epidural Anesthesia for Knee Arthroscopic Surgery in Elderly Patients[J].Popular Science & Technology,2020,22(10):61-63.
点击复制

老年患者膝关节镜手术腰麻联合硬膜外麻醉中应用盐酸右美托咪定的镇痛镇静效果及 对手术应激的影响()
分享到：

《大众科技》[ISSN:1008-1151/CN:45-1235/N]

卷:
22
期数:
2020年10
页码:
61-63
栏目:
医药与卫生
出版日期:
2020-10-20

文章信息/Info

Title:
Analgesic and Sedative Effect of Dexmedetomidine Hydrochloride in Combined Spinal and Epidural Anesthesia for Knee Arthroscopic Surgery in Elderly Patients
作者:
谭国政　李　锋　赖丽娜
（广西梧州市中医医院，广西 梧州 543002）
关键词:
老年; 膝关节镜手术; 腰麻; 硬膜外麻醉; 盐酸右美托咪定; 镇痛镇静; 手术应激
Keywords:
elderly knee arthroscopic surgery spinal anesthesia epidural anesthesia dexmedetomidine hydrochloride analgesia and sedation surgical stress
文献标志码:
A
摘要:
目的：探究老年患者膝关节镜手术腰麻联合硬膜外麻醉中应用盐酸右美托咪定的镇痛镇静效果及对手术应激的影响。方法：选取2016年2月至2020年6月梧州市中医医院收治的103例老年膝关节镜手术患者为研究对象，按照随机数字表分为两组，术中均行腰麻联合硬膜外麻醉，观察组（n=52）静脉泵注盐酸右美托咪定，对照组（n=51）静脉泵注等量生理盐水，对比两组术后相关指标、不同时间点血流动力学指标HR（心率）、SBP（收缩压）、DBP（舒张压）、应激指标E（肾上腺素）、NE（去甲肾上腺素）、Cor（皮质醇）水平变化情况、不良反应发生情况。结果：与对照组比较，观察组术后恢复时间、神经阻滞时间更短，Ramasy评分、VAS评分更低（P＜0.05）；与对照组比较，观察组术前5 min、手术开始时、开始手术后5 min、开始手术后10 min、结束手术时的SBP、DBP、HR均更低（P＜0.05）；且与对照组比较，观察组围术期SBP、DBP、HR波动幅度更小（P＜0.05）；与对照组比较，观察组手术结束时、术后24 h时的E、NE、Cor水平均更低（P＜0.05）；观察组不良反应发生率为5.77%，低于对照组的25.49%（P＜0.05）。结论：老年患者膝关节镜手术腰麻联合硬膜外麻醉中应用盐酸右美托咪定的镇痛镇静效果理想，且手术应激反应轻。
Abstract:
Objective: To explore the analgesic and sedative effect of dexmedetomidine hydrochloride in elderly patients undergoing knee arthroscopic surgery combined with epidural anesthesia and its influence on surgical stress. Methods: 103 elderly patients with knee arthroscopic surgery in Wuzhou Hospital of Traditional Chinese Medicine from February 2016 to June 2020 were selected as the research objects, and they were divided into two groups according to the random number table. All patients underwent lumbar anesthesia combined with epidural anesthesia during the operation. The patients in the observation group (n=52) were given dexmedetomidine hydrochloride by intravenous pump, and the control group (n=51) were given the same amount of normal saline by intravenous infusion. The changes of postoperative related indexes, hemodynamic indexes HR (heart rate), SBP (systolic blood pressure), DBP (diastolic blood pressure), stress index E (adrenaline), NE (norepinephrine), Cor (cortisol) levels and adverse reactions were compared between the two groups. Results:　Compared with the control group, the postoperative recovery time and nerve block time of the observation group were shorter, and the ramasy score and VAS score were lower (P＜0.05) Compared with the control group, SBP, DBP and HR of the observation group were lower at 5min before surgery, 5min after surgery, 10min after surgery, and at the end of surgery (P＜0.05). Compared with the control group, the fluctuation range of SBP, DBP and HR in the perioperative period of the observation group was smaller (P＜0.05). Compared with the control group, E, NE and Cor levels in the observation group were lower at the end of surgery and 24h after surgery (P＜0.05). The incidence of adverse reactions in the observation group was 5.77%, lower than 25.49% in the control group (P＜0.05). Conclusion: dexmedetomidine hydrochloride has ideal analgesic and sedative effect in elderly patients with knee arthroscopic surgery combined with epidural anesthesia, and the surgical stress response is light.

参考文献/References:

[1]　胡晓晖，李法印，张鹏，等. 膝关节镜清理联合腓骨近端截骨在膝内侧间室病变骨关节炎治疗中的临床研究[J]. 中国现代医学杂志，2018，28(9): 88-93. [2]　曹秀玲，王一男，徐丽，等. 小剂量腰麻-硬膜外联合阻滞麻醉与硬膜外阻滞麻醉对妊娠期高血压剖宫产产妇炎症因子的影响[J]. 中国临床医生杂志，2019，47(2): 223-225. [3]　千磊. 右美托咪定的神经保护作用及其相关机制的研究进展[J]. 实用医院临床杂志，2019，16(3): 229-231. [4]　周文君，崔军凯，柳梅. 右美托咪定在合并肺源性心脏病患者腹部手术围术期的心肌保护作用研究[J]. 中国心血管病研究，2018，16(9): 836-839. [5]　王晓亚，任猛，王浩，等. 关节镜手术联合透明质酸钠在老年膝骨关节炎治疗的效果及炎性因子的影响[J]. 河北医药，2019，41(8): 1235-1237. [1]　林美铃. 新时代强化基层工会维权职能的思考[J]. 天津市工会管理干部学院学报，2019(3): 8-13. [2]　张海红. 新媒体时代优化职工维权服务所遇到的难点和对策研究[J]. 记者观察，2020(12): 113. [3]　孟俊国. 发挥职能作用 探索和改进企业工会工作[J]. 支部建设，2020(14): 47-49. [4]　粟斌. 高举维护职工合法权益旗帜 竭诚服务职工群众[J]. 工会博览，2019(33): 23-26. [5]　刘静. 新形势下做好工会工作的几点建议[J]. 中外企业家，2020(13): 92. （上接第63页） [6]　汪利凤，谢郭豪，李亚楠，等. 右美托咪定复合星状神经节阻滞对气管插管反应的影响[J]. 中国药物与临床，2019，19(8): 1275-1276. [7]　陈成帷，潘哲尔，周也立，等. 常规止血带下膝关节镜手术后早期深静脉血栓的发生率及危险因素分析[J]. 中国骨伤，2018，31(9): 829-834. [8]　王圆方，林江涛. 糖皮质激素敏感性降低的分子机制研究进展[J]. 中国呼吸与危重监护杂志，2018，17(4): 426-429. [9]　安彬，陆良愿，娄志超，等. 妇科腹部手术中不同BIS值区间与术后机体应激反应的相关性[J]. 中国医师杂志，2019(11): 1728-1730.

相似文献/References:

[1]林 芃.复方丹参滴丸对老年颈动脉粥样硬化患者金属蛋白酶的影响[J].大众科技,2022,24(08):64.
　Effect of Compound Danshen Dripping Pills on Metalloproteinases in Elderly Patients with Carotid Atherosclerosis[J].Popular Science & Technology,2022,24(10):64.
[2]孔根禄,刘世发,孔维旭.永靖县老年人群良性前列腺增生发病相关因素分析[J].大众科技,2019,21(06):103.
　Analysis of Risk Factors of Benign Prostatic Hyperplasia in theAged of Yongjing County[J].Popular Science & Technology,2019,21(10):103.
[3]董鹏飞 覃菊艳.重症医学科老年内科患者贫血状况分析[J].大众科技,2021,23(7):58.
　Analysis of Anemia in Geriatric Internal Medicine Patients in Intensive Care Unit[J].Popular Science & Technology,2021,23(10):58.

备注/Memo

备注/Memo:
【收稿日期】2020-08-07 【作者简介】谭国政（1984－），男（瑶族），梧州市中医医院主治医师，研究方向为临床麻醉。
更新日期/Last Update: 2020-11-19