| 陈秋霞,林惠娟,张小燕,刘建东,易菲妮.术前右美托咪定滴鼻联合FICB对老年髋部骨折手术患者围术期血流波动、麻醉质量和苏醒期躁动的影响[J].,2024,(10):1951-1954 |
| 术前右美托咪定滴鼻联合FICB对老年髋部骨折手术患者围术期血流波动、麻醉质量和苏醒期躁动的影响 |
| Effect of Preoperative Nasal Drip of Dexmedetomidine Combined with FICB on Perioperative Hemodynamics, Anesthesia Quality and Emergence Agitation in Elderly Patients Undergoing Hip Fracture Surgery |
| 投稿时间：2023-11-24 修订日期：2023-12-21 |
| DOI：10.13241/j.cnki.pmb.2024.10.031 |
| 中文关键词: 髋部骨折 右美托咪定 髂筋膜间隙阻滞 血流波动 麻醉质量 苏醒期躁动 |
| 英文关键词: Hip fracture Dexmetomidine Fascia iliaca compartment block Hemodynamic fluctuation Anesthesia quality Emergence agitation |
| 基金项目:南京军区医学科技创新面上项目（14MS090） |
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| 中文摘要: |
| 摘要 目的：分析术前右美托咪定滴鼻联合髂筋膜间隙阻滞（FICB）对老年髋部骨折手术患者围术期血流波动、麻醉质量和苏醒期躁动的影响。方法：选取解放军联勤保障部队第909医院收治的老年髋部骨折手术患者为研究对象并采用随机数字表法分为对照组（75例，接受FICB镇痛）和观察组（75例，给予术前右美托咪定滴鼻联合FICB镇痛），比较患者血流波动、麻醉质量、苏醒期躁动以及不良反应。结果：两组患者进入待术间时平均动脉压（MAP）及心率（HR）水平比较差异无统计学意义（P＞0.05），但观察组患者离待术间、过床后即刻、体位摆放成功时及腰麻穿刺结束时的MAP及HR水平均显著低于对照组（P＜0.05）；观察组FICB起效时间显著低于对照组（P＜0.05）；观察组术后1 h、2 h、4 h及6 h的数字可视疼痛程度（NRS）评分均显著低于对照组（P＜0.05）；观察组拔管后10 min、20 min及60 min的镇静-躁动（Riker-SAS）评分具显著低于对照组（P＜0.05）；两组患者不良反应发生率比较差异无统计学意义（P＞0.05）。结论：针对老年髋部骨折手术患者采用术前右美托咪定滴鼻联合FICB有利于患者血流动力学保持稳定，缩短FICB起效时间并提高患者镇痛效果，同时可显著降低患者苏醒期躁动，且不良反应发生较少。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the effect of preoperative nasal drip of dexmedetomidine combined with fascia iliaca compartment block (FICB) on perioperative hemodynamics, anesthesia quality and emergence agitation in elderly patients undergoing hip fracture surgery. Methods: Elderly patients who underwent hip fracture surgery in No.909 Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army were selected as the research subjects and randomly divided into control group (75 cases, FICB) and observation group (75 cases, preoperative nasal drip of dexmedetomidine combined with FICB). Perioperative hemodynamics, anesthesia quality, emergence agitation and adverse reactions were compared between groups. Results: The two groups had similar mean arterial pressure (MAP) and heart rate (HR) when entering the waiting room (P>0.05). The observation group had significantly lower MAP and HR than the control group when leaving the waiting room, immediately after transfer from the bed, when the body position was successfully placed and at the end of lumbar anesthesia puncture(P<0.05). The onset time of FICB in the observation group was significantly shorter than that in the control group (P<0.05). The NRS scores of the observation group at 1 h, 2 h, 4 h and 6 h after surgery were significantly lower than those of the control group (P<0.05). The Riker SAS scores of the observation group at 10 min, 20 min and 60 min after extubation were significantly lower than those of the control group(P<0.05). The incidences of adverse reactions in the two groups were close(P>0.05). Conclusion: Preoperative nasal drip of dexmedetomidine combined with FICB is beneficial for maintaining stable hemodynamics, shortening the onset time of FICB and improving the analgesic effect in patients undergoing hip fracture surgery. Meanwhile, it can significantly reduce emergence agitation, without increasing adverse reactions. |
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