右美托咪定对老年患者全髋关节置换术后早期睡眠质量影响.docVIP

右美托咪定对老年患者全髋关节置换术后早期睡眠质量影响 　　[摘要] 目的 探讨右美托咪定对老年患者全髋关节置换术后早期睡眠质量的影响。 方法 择期在蛛网膜下腔阻滞下行全髋关节置换手术的老年患者40例，ASA分级Ⅱ～Ⅲ级，随机分为两组（n=20），右美托咪定组患者予右美托咪定0.5 μg/kg，持续泵注10 min后，以0.2 μg/（kg?h）持续泵注至手术结束；对照组泵注等体积的生理盐水。连续监测患者术日晚20：00～术后第2天8：00期间的脑电双频指数（BIS）得出总睡眠时间和觉醒时间；并每隔2 h记录平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO2）和呼吸频率（RR）；记录术后第2天8：00时患者的PSQI量表评分。 结果 两组患者术日晚20：00～术后第2天8：00间，对照组与右美托咪定组每隔2 h的MAP、HR、SpO2及RR比较，差异均无统计学意义（P0.05）；与对照组相比较，右美托咪定组患者总睡眠时间显著延长，PSQI值明显降低，且均值小于7分，差异有统计学意义（P0.05）。 结论 右美托咪定应用于择期在蛛网膜下腔阻滞下行全髋关节置换术的老年患者，能提高患者术后早期睡眠质量，值得临床推广应用。 　　[关键词] 右美托咪定；老年人；睡眠质量；全髋关节置换术 　　[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701（2018）07-0093-04 　　[Abstract] Objective To investigate the effect of dexmedetomidine on the early sleep quality in elderly patients after total hip arthroplasty. Methods 40 cases of elderly patients undergoing selective total hip arthroplasty under subarachnoid block， with ASA grade Ⅱ-Ⅲ， were randomly divided into two groups（n=20）. Patients in the dexmedetomidine group were given dexmedetomidine of 0.5 μg/kg. After continuous pump of 10 min， 0.2 μg/（kg?h） was kept for continuous pump until the end of surgery； the control group was pumped with equal volumes of normal saline. The EEG bispectral index（BIS） was continuously monitored on the day of surgery from 20：00 pm to 8：00 am on the second day of surgery， and the total sleep time and waking time were obtained； mean arterial pressure（MAP）， heart rate（HR）， pulse oxygen saturation（SpO2） and respiratory rate（RR） were recorded at the interval of every 2 hours. The patients PSQI score was recorded at 8：00 am on the second day after surgery. Results There were no statistically significant differences in MAP， HR， SpO2 and RR between the control group and the dexmedetomidine group at the interval of every 2 hours between 20：00 and 8：00 on the second day after surgery（P0.05）； compared with the control group， the total sleep time in the patients in the dexmedetomidine group was significantly longer， PSQI value was decreased significantly， and