Dexmedetomidine dose for epidural anesthesia in the elderly knee arthroplasty
10.3969/j.issn.2095-4344.2015.22.006
- VernacularTitle:高龄膝关节置换过程中应用右美托咪啶硬膜外麻醉剂量的选择
- Author:
Hongyi SHI
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2015;(22):3472-3476
- CountryChina
- Language:Chinese
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Abstract:
BACKGROUND:Dural elderly knee arthroplasty anesthesia is a common mode of anesthesia. Dexmedetomidine, because of good analgesic effects, is widely applied to epidural anesthesia in elderly knee replacement, but different applied dose of dexmedetomidine may lead to different results. OBJECTIVE:To explore the effects of different doses of dexmedetomidine for epidural anesthesia in elderly knee arthroplasty. METHODS:A total of 75 cases of older patients undergoing knee replacement surgery were selected and randomly divided into dexmedetomidine loading and maintenance group (25 cases), dexmedetomidine group (25 cases), and the normal saline group (25 cases), and then they were given smal doses of dexmedetomidine loading and maintenance, dexmedetomidine maintenance, intravenous infusion of normal saline. Blood pressure, heart rate, Calm/Alert Standard Score and the operation degree of forgetting were observed and compared in the three groups. The time points included T0 (after epidural anesthesia), T1 (3 minutes after medication), T2 (5 minutes after medication), T3 (10 minutes after medication), T4 (15 minutes after medication), and T5 (30 minutes after medication). RESULTS AND CONCLUSION:After the use of drugs, blood pressure and heart rate were decreased in the dexmedetomidine loading and maintenance group and dexmedetomidine group. Blood pressure and heart rate were significantly lower in the dexmedetomidine loading and maintenance group than that of dexmedetomidine maintenance group (P < 0.05). Moreover, it was slowest in T3 phase and in T4 phase in the dexmedetomidine group (P < 0.05). After 5 minutes of medication, Calm/Alert Standard Score was decreased in the dexmedetomidine loading and maintenance group and dexmedetomidine group. In T3 phase, deep sedation and heart rate decreased significantly in the dexmedetomidine loading and maintenance group; above symptoms could be improved by giving atropine. In T4 phase, score was lowest in the dexmedetomidine group (P < 0.05), but deep sedation was not found; the decreased degree of blood pressure and heart rate was lighter in the dexmedetomidine group than in the dexmedetomidine loading and maintenance group. The complete oblivion extents of the operation-related procedures were respectively 72%, 68% and 0% in the dexmedetomidine loading and maintenance group, dexmedetomidine group and normal saline group. Above extent was significantly greater in the dexmedetomidine loading and maintenance group and dexmedetomidine group than in the normal saline group (P < 0.05). No significant difference was detected between groups (P > 0.05). These findings suggest that in elderly patients undergoing knee replacement, smal dose of dexmedetomidine continuous infusion for epidural anesthesia can achieve good effects on analgesia and sedation, can eliminate the bad memories for patients with operation, and is a scientific mode of anesthesia.
