在接受全髋关节置换术的老年患者中,超声引导下连续性囊周神经组阻滞中加入右美托咪定的效果。

Rejuvenation research Pub Date : 2024-08-01 Epub Date: 2024-05-13 DOI:10.1089/rej.2024.0014
Xia Li, Liang Chen, Yunyun Sun, Yuanhai Li
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摘要

全髋关节置换术(THA)是解决髋关节问题的一种非常有效的干预措施,但围术期疼痛的管理仍然是一项重大挑战。在这项研究中,我们旨在调查在超声引导下连续性囊周神经组阻滞(PENGB)中使用右美托咪定辅助罗哌卡因对接受全髋关节置换术的老年患者的影响。我们对 112 名接受 THA 手术的老年患者进行了回顾性分析。这些患者被分为两组:对照组(仅接受罗哌卡因)和 DEX 组(接受罗哌卡因联合右美托咪定)。我们评估了各种参数,包括血液动力学数据、使用视觉模拟量表(VAS)评估的术后疼痛程度、使用蒙特利尔认知评估(MoCA)测量的认知状态以及血清标记物(S100β 和 GFAP)。我们的研究结果显示,DEX 组患者术后血压和血氧饱和度的稳定性有所改善。此外,右美托咪定组患者在术后 6 小时和 12 小时的疼痛程度明显降低,疼痛缓解时间延长。此外,右美托咪定与术后早期认知功能的保护有关。对血清标志物的分析表明,加入右美托咪定可保护认知功能。总之,我们的研究强调了在基于罗哌卡因的 PENGB 中加入右美托咪定对老年 THA 患者的多方面益处。
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Effects of Dexmedetomidine Added to Ropivacaine in Ultrasound-Guided Continuous Pericapsular Nerve Group Block Among Elderly Patients Undergoing Total Hip Arthroplasty.

Total hip arthroplasty (THA) is a highly effective intervention for addressing hip joint issues, yet managing perioperative pain remains a significant challenge. In this study, we aimed to investigate the impact of supplementing ropivacaine with dexmedetomidine in ultrasound-guided continuous pericapsular nerve group block (PENGB) among elderly patients undergoing THA. We conducted a retrospective analysis involving 112 elderly patients who underwent THA. These patients were divided into two groups: the Control group, receiving ropivacaine alone, and the DEX group, receiving ropivacaine combined with dexmedetomidine. We evaluated various parameters including hemodynamic data, postoperative pain levels assessed using the Visual Analog Scale, cognitive status measured with the Montreal Cognitive Assessment, and serum markers (S100β and GFAP). Our findings revealed that the DEX group exhibited improved stability in blood pressure and oxygen saturation following surgery. Moreover, patients in the DEX group reported significantly lower levels of pain at 6 and 12 hours postsurgery, with a prolonged duration of pain relief. Furthermore, dexmedetomidine administration was associated with preserved cognitive function during the early postoperative period. Analysis of serum markers suggested potential cognitive protection conferred by the addition of dexmedetomidine. Overall, our study underscores the multifaceted benefits of incorporating dexmedetomidine into ropivacaine-based PENGB for elderly THA patients.

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