摘要
目的观察术中持续输注右美托咪定对腰麻下高龄患者髋部骨折术后谵妄(POD)的影响。方法选择髋部骨折患者80例,年龄80~95岁,美国麻醉医师学会分级Ⅱ~Ⅲ级,按照随机数字表法将患者均分为右美托咪定组(D组)和对照组(C组),每组40例。侧卧位下行L3-4或L2-3蛛网膜下腔阻滞,药物采用布比卡因7.5~10 mg(脑脊液稀释至2~3 mL)。D组于手术开始时静脉输注右美托咪定0.2 g.kg^-1.h^-1至手术结束,C组输注等容量生理盐水。术后5d采用谵妄评定法(CAM)对每例患者进行评估,观察POD的发生情况。结果D组POD发生率为7.5%,C组为10%,2组间的差异无统计学意义(P>0.05)。结论术中持续输注小剂量右美托咪定对高龄患者腰麻下髋部骨折POD无影响。
Objective To observe the effect of continuous intraoperative dexmedetomidine infusion on postoperative delirium(POD)in elderly patients with hip fracture under spinal anesthesia.Methods Eighty ASAⅡorⅢpatients with hip fractures were selected,aged 80~95 years old,and they were randomly divided into dexmedetomidine group(group D)and control group(group C),40 cases per group.L3-4 or L2-3 subarachnoid block was performed in lateral decubitus position.Bupivacaine 7.5~10 mg((diluted to 2-3 m L with cerebrospinal fluid)was used.Group D received intravenous infusion of dexmedetomidine 0.2 g.kg^-1.h^-1 from beginning of incision to end of operation,and group C was infused with equal volume of normal saline.Five days after operation,each patient was assessed by Confusion Assessment Method(CAM)and the occurrence of POD was observed.Results The incidence of POD was 7.5%in group D and 10%in group C.There was no significant difference between the two groups(P>0.05).Conclusion Continuous infusion of low-dose dexmedetomidine during operation has no effect on postoperative POD in elderly patients with hip fracture under spinal anesthesia.
作者
徐文庆
沈伟
覃静
张士民
吴华彬
Xu Wenqing;Sheng Wei;Qin Jing;Zhang Shimin;Wu Huabin(Department of Anesthesiology,Tinglin Hospital,Jinshan District,Shanghai,201505,P.R.China)
出处
《老年医学与保健》
CAS
2020年第5期851-852,868,共3页
Geriatrics & Health Care
基金
上海市金山区科学技术创新资金项目(2017-3-14)。
