Effects of various doses of dexmedetomidine combined with sufentanil on outcomes of thoracolumbar fracture surgery
10.3760/cma.j.cn341190-20240518-00591
- VernacularTitle:不同剂量右美托咪定复合舒芬太尼用于胸腰椎骨折手术的效果比较
- Author:
Na YAO
1
;
Yan WANG
1
Author Information
1. 河南省洛阳正骨医院（河南省骨科医院）麻醉科，洛阳 471000
- Publication Type:Journal Article
- Keywords:
Spinal fractures;
Thoracic vertebrae;
Lumbar vertebrae;
Anesthesia, general;
Dose-response relationship,drug;
Dexmedetomidine;
Sufentanil
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(1):88-92
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of different doses of dexmedetomidine combined with sufentanil on outcomes of thoracolumbar fracture surgery.Methods:A randomized controlled study was conducted involving 100 patients with thoracolumbar spine fractures who underwent general anesthesia at Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital) from May 2022 to May 2023. The patients were randomly assigned to either a low-dose dexmedetomidine group ( n = 50) or a high-dose dexmedetomidine group ( n = 50) using a random number table method. The high-dose dexmedetomidine group received an infusion of dexmedetomidine at a rate of 0.8 μg·kg -1·h -1, along with sufentanil at 0.02 μg·kg -1·h -1. In contrast, the low-dose dexmedetomidine group received dexmedetomidine at a rate of 0.5 μg·kg -1·h -1, also combined with sufentanil at 0.02 μg·kg -1·h -1. Clinical indicators, oxidative damage, platelet activation markers, and the incidence of adverse reactions were compared between the two groups. Results:At extubation and 20 minutes post-extubation, the Visual Analogue Scale scores for the high-dose dexmedetomidine group were (4.12 ± 0.05) points and (2.65 ± 0.12) points, respectively, which were significantly lower than those in the low-dose dexmedetomidine group [(5.23 ± 0.12) points, (4.23 ± 0.52) points, t = -60.38, -20.94, both P < 0.001]. At extubation and 20 minutes post-extubation, the Ramsay sedation scores for the high-dose dexmedetomidine group were (5.02 ± 0.36) points and (5.65 ± 0.12) points, respectively, which were significantly higher than those in the low-dose dexmedetomidine group ( t = 16.72, 35.16, both P < 0.001). At 24 hours post-surgery, the serum levels of glutathione peroxidase and superoxide dismutase in the high-dose dexmedetomidine group were (412.23 ± 52.12) U/L and (98.65 ± 10.23) U/L, respectively, which were significantly lower than those in the control group [(452.36 ± 50.23) U/L, (114.25 ± 11.21) U/L, t = -4.74, -7.27, both P < 0.05]. The levels of thromboxane A2 and platelet alpha-granule membrane protein 140 in the high-dose dexmedetomidine group were (362.23 ± 20.32) ng/L and (20.12 ± 2.56) μg/L, respectively, both of which were significantly lower than those in the control group [(412.03 ± 21.23) ng/L, (25.64 ± 3.01) μg/L, t = -11.98, -9.88, both P < 0.05]. The incidence of adverse reactions in the high-dose dexmedetomidine group was 12% (6/50), which was significantly lower than that in the low-dose dexmedetomidine group [30% (15/50), χ2 = 4.88, P < 0.001]. Conclusions:Anesthesia with high-dose dexmedetomidine can reduce oxidative damage responses, inhibit platelet activation, improve clinical outcomes, and decrease the incidence of adverse reactions in patients undergoing surgery for thoracolumbar spine fractures.
