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| 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 |
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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.
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Received: 03 June 2025
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[1] 彭光福,杨述华.髋关节置换术治疗老年股骨颈骨折的决策分析[J].中国骨与关节杂志,2021,10(6):401-404.
[2] 王旭,刘胜群.右美托咪定在心脏瓣膜置换术中对凝血功能的影响[J].重庆医学,2022,51(2):247-251.
[3] 单涛,韩流,葛德高等.超声引导下髋关节囊周围神经阻滞联合椎管内麻醉在老年患者全髋关节置换术中的应用[J].临床麻醉学杂志,2021,37(5):458-461.
[4] 赵奎,张梅刃,曾啸,等.耳穴压豆疗法对老年髋部骨折患者术后谵妄、睡眠时间及焦虑水平的影响[J].现代生物医学进展,2021,21(12):2386-2390.
[5] 龙焱,盛志锋,许旭东,等.小剂量羟考酮对老年全髋关节置换术患者全身麻醉苏醒期血流动力学及应激反应的影响[J].医学综述,2023,29(17):3524-3530.
[6] 王亚群,邱新建,彭杰成,等.老年髋关节置换术中实施丙泊酚闭环靶控输注麻醉的效果及对患者术后谵妄风险的影响[J].临床和实验医学杂志,2024,23(10):1118-1120.
[7] 朱磊磊,邬薇薇,高武,等.BIS指导下丙泊酚联合瑞芬太尼靶控输注对老年髋关节置换患者术中丙泊酚用量和术后谵妄发生率的影响[J].河北医学,2024,30(3):429-435.
[8] 杨潜前,曹金林,孙建良.不同剂量右美托咪定对体外循环心脏手术患者认知功能和应激反应的影响[J].浙江医学,2020,42(20):2209-2213.
[9] 李波,王春燕.静脉注射不同剂量右美托咪定对老年脑科手术病人喉镜和气管插管时血流动力学的影响[J].中西医结合心脑血管病杂志,2020,18(2):377-380. |
| [1] |
. [J]. journal1, 2025, 45(6): 58-61. |
| [2] |
. [J]. journal1, 2025, 45(6): 69-71. |
| [3] |
. [J]. journal1, 2025, 45(6): 142-144. |
| [4] |
Luo Dan, Li Jin. The Effect of Rocuronium Bromide and Phenylsulfonyl cis Atracurium Anesthesia on Anesthesia Efficacy and Complications in Patients undergoing Cholecystectomy[J]. journal1, 2025, 45(5): 25-27. |
| [5] |
. [J]. journal1, 2025, 45(5): 65-66. |
| [6] |
. [J]. journal1, 2025, 45(5): 76-77. |
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2025, Vol. 45 
