Effects of Different Doses of Dexmedetomidine Combined with Intraspinal Anesthesia on Hemodynamic Stability and Postoperative Delirium in Elderly Patients Undergoing Hip Surgery
Yue Xiaojuan, Sun Kunpeng, Tang Xiaomin
Anesthesiology of Zhengzhou Guancheng Hospital of TCM,Zhengzhou 450000
Abstract：Objective To investigate the effects of different doses of dexmedetomidine(Dex)combined with intraspinal anesthesia on hemodynamic stability and postoperative delirium in elderly patients undergoing hip surgery. Methods Eighty elderly patients who underwent hip surgery were selected.Using a random number table,they were divided into two groups.Both groups received intraspinal anesthesia combined with Dex sedation regimen.The maintenance doses for the low-dose group(40 cases)and the high-dose group(40 cases)were 0.2 and 0.4 μg/(kg·h),respectively.The sedative effect [Observer's Assessment of Alertness/Sedation(OAA/S)score and Ramsay sedation scale(RSS)score],hemodynamic indexes [heart rate(HR)and mean arterial pressure(MAP)],stress indexes [norepinephrine(NE),epinephrine(E)and cortisol(Cor)],and occurrence of postoperative delirium and adverse reactions were compared between the two groups. Results The two groups had similar OAA/S and RSS scores at different time points(P>0.05).HR and MAP of the two groups were comparable before anesthesia(T0)and at the end of surgery(T3)(P>0.05).At 20 min after anesthesia(T1),decreases in HR and MAP were significantly greater in the high-dose group than in the low-dose group(P<0.05).HR and MAP of the high-dose group were significantly lower at T1 and T3 compared to T0(P<0.05).However,the low-dose group only showed a significant decrease at T1(P<0.05).At 60 min after anesthesia(T2)and T3,the levels of NE,E and Cor in the high-dose group were significantly higher than those in the low-dose group(P<0.05).The incidence rates of postoperative delirium in the low-dose group and the high-dose group were respectively.The total incidence of adverse reactions in the low-dose group wasin the high-dose group(P>0.05). Conclusion Low-dose Dex combined with intraspinal anesthesia can achieve better effects in maintaining hemodynamic stability,controlling stress response,and reducing adverse reactions.The sedative effect and prevention of postoperative delirium are comparable to high-dose Dex,making it more suitable for intraoperative sedationof elderly patients undergoing hip surgery.
岳晓娟, 孙鲲鹏, 唐晓敏. 不同剂量右美托咪定联合椎管内麻醉对老年髋关节手术患者血流动力学稳定、术后谵妄的影响[J]. 哈尔滨医药, 2025, 45(6): 39-41.
Yue Xiaojuan, Sun Kunpeng, Tang Xiaomin. Effects of Different Doses of Dexmedetomidine Combined with Intraspinal Anesthesia on Hemodynamic Stability and Postoperative Delirium in Elderly Patients Undergoing Hip Surgery. journal1, 2025, 45(6): 39-41.
2025, Vol. 45 
