Volume 20 Issue 4
Apr.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(4): 606-610
LIU Lu, LIANG Su-rong, PAN Zai-li, XU Huan-hang. Intravenous optimization effect of dexmedetomidine combined with low dose remifentanil on elderly patients undergoing hip arthroplasty[J]. Chinese Journal of General Practice, 2022, 20(4): 606-610. doi: 10.16766/j.cnki.issn.1674-4152.002411
Citation: LIU Lu, LIANG Su-rong, PAN Zai-li, XU Huan-hang. Intravenous optimization effect of dexmedetomidine combined with low dose remifentanil on elderly patients undergoing hip arthroplasty[J]. Chinese Journal of General Practice, 2022, 20(4): 606-610. doi: 10.16766/j.cnki.issn.1674-4152.002411
shu

Intravenous optimization effect of dexmedetomidine combined with low dose remifentanil on elderly patients undergoing hip arthroplasty

doi: 10.16766/j.cnki.issn.1674-4152.002411
  • 1.

    Department of Anesthesiology, Wenchang People ' s Hospital, Wenchang, Hainan 571300, China

Funds:

 2018175

  • Received Date: 2021-04-10
    Available Online: 2022-08-20
    Abstract
  •   Objective  To investigate the anesthetic effect of dexmedetomidine (DEX) combined with low dose remifentanil on elderly patients undergoing hip arthroplasty with lumbar plexus-sciatic nerve block.  Methods  A total of 90 elderly patients undergoing hip arthroplasty in our hospital from July 2018 to July 2020 were randomly divided into group A, B and C, with 30 patients in each group. Group A was given DEX pump injection, group B was given small dose remifentanil pump injection, group C was given small dose remifentanil continuous pump injection combined with DEX pump injection, the injection dose was the same as that of group A and B. All groups were treated with lumbar plexus-sciatic nerve block guided by ultrasound combined with nerve stimulation 10 minutes after administration. Hemodynamics, analgesia and sedation effects were observed and compared in each group, and patients ' satisfaction with anesthesia effect was compared.  Results  After nerve block (T1), MAP of group B and C was significantly lower than that of group A (all P < 0.05). At 15min (T2), 30 min (T3) after operation and operation completion (T4), the MAP of group C was significantly lower than that of groups A and B (all P < 0.05), and that of group B was significantly lower than that of group A (all P < 0.05). At T2-T4, HR in group C was significantly lower than that in groups A and B (all P < 0.05). At T1-T4, RR in groups B and C was significantly lower than that in group A (all P < 0.05). At T1-T4, VAS score in group C was significantly lower than that in groups A and B (all P < 0.01). At T1-T2, BIS in group C was significantly lower than that in groups A and B (all P < 0.01), and BIS in group A was significantly lower than that in group B (all P < 0.05). At T3-T4, BIS in group B was significantly higher than that in group A and C (all P < 0.01). The anesthesia satisfaction of group C (96.67%) was significantly higher than that of group A (66.67%) and B (66.67%, χ2=9.017, P=0.003).  Conclusion  In elderly patients undergoing hip replacement under lumbar plexus-sciatic nerve block anesthesia, intraoperative administration of DEX combined with low-dose remifentanil continuous pumping can effectively maintain hemodynamic stability, and provide better analgesia and sedative effects, with small adverse reactions, which is worthy of clinical promotion.

     

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