Study On The Effect Of Dexmedetomidine In Elderly Patients With Lumbar Epidural Anesthesia

Objective:To observe and compare the elderly patients with dexmedetomidine and midazolam on combined spinal epidural anesthesia produced by sedative effect,and the effect of hemodynamics and respiration,the efficacy and safety of elderly patients with sedation of dexmedetomidine as the combined spinal epidural anesthesia.Methods:A total of 80 patients in The First Affiliated Hospital of Henan University of Science and Technology and The First Affiliated Hospital of Nanyang Medical College from June 2015 to June 2016 undergoing lower abdomen and lower limb surgery and combined spinal epidural anesthesia patients,male 45 cases,female 35 cases,average age(72.42±5.83)years old,ASA ?~ ?class.Randomly divided into midazolam group(group M)and dexmedetomidine group(D group),40 cases in each group.After the exact effect of anesthesia,patients in the M group within 10 min were given doses of 0.05mg/kg of midazolam,followed by 0.1mg/kg/h pump maintenance,D group were given doses of dexmedetomidine 0.5?g/kg in 10 min,and then with the same concentration of 0.3?g/kg/h pump maintenance.The 2 groups were observed and compared before administration(T0),after administration of 10min(T1),20min(T2),30min(T3),60min(T4)with a mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),oxygen saturation(SpO2)and alterness/calm visual score(OAA/S score),and record adverse reactions in the 2 groups and the incidence of postoperative 24 h follow-up of surgery degree of forgetting.Statistics and data processing using the SPSS 17.0 software,measurement data between groups using independent sample t test,count data using chi square test facility,P<0.05 showed the difference was statistically significant.Results : Compared with T0,T2~T4,MAP in M group were decreased significantly(P<0.05),and significantly lower than that of D group(P<0.05);T1~T4,D group and M group of patients with HR were compared,the difference was not statistically significant(P>0.05);compared with T0,T2~T4,RR and SPO2 in M group were significantly decreased(P<0.05),compared with D group,the difference was statistically significant(P<0.05);compared with T0,T1~T4 and OAA/S scores of the 2 groups were significantly decreased(P<0.05)and T2~T4 M group was significantly lower than D group(P<0.05);M group of patients with adverse reaction rate was significantly higher than that in D group(P<0.05);group M patients with anterograde amnesia rate were compared with group D,the difference was not statistically significant(P>0.05).Conclusion:1.Compared with M group,the inhibition effect of D group was weak,the hemodynamics was stable,and the incidence of adverse reactions was low.2.Dexmedetomidine can maintain a good sedative effect,easy to wake up,for elderly patients with respiratory effects and mild nausea and vomiting,body movement,cough and other adverse reaction rate is low,can inhibit the chills,intravenous sedatives is a kind of ideal.