目的：右美托咪定用于老年人髋关节置换术的效果观察。方法：随机选取2012年3月-2014年6月在本院行髋关节置换术的老年患者60例，并按入院的先后顺序分为A组、B组和C组，每组20例。A组患者静脉泵注4μg/mL右美托咪定10 min后，维持0.2μg/（kg·h）；B组静脉泵注4μg/mL右美托咪定10 min后，维持0.4μg/（kg·h）；C组静脉注射0.9%氯化钠溶液。观察并记录三组患者在麻醉前后、手术中和手术后的心率（HR）、平均动脉压（MAP）和血氧饱和度（SPO2）水平。记录三组患者的丙泊酚用量和清醒时间。同时，采用视觉模拟评分系统（VAS）对患者清醒时和手术后1 h的疼痛程度进行评分。观察患者手术后不良反应的发生率。结果：麻醉后，B组患者的SpO2水平显著低于A组和C组，差异有统计学意义（P<0.05）；B组患者的丙泊酚用量低于A组和C组（P<0.05）；A组患者的VAS评分低于B组和C组（P<0.05）；B组患者的低氧血症发生率高于A组和C组（P<0.05）。结论：右美托咪定用于老年人髋关节置换术，镇静效果显著，对呼吸抑制较轻，不良反应少。%Objective:To observe the clinical effect of Dexmedetomidine for elderly patients undergoing total hip replacement.Method:60 elderly patients with total hip replacement were selected and randomly divided into 3 groups, 20 cases in each group.Patients in group A received a 4 μg/mL Dexmedetomidine intravenous infusion of 10 min, maintaining 0.2 g/(kg·h); patients in group B received a 4 μg/mL Dexmedetomidine intravenous infusion of 10 min, maintaining 0.4 g/(kg·h); patients in group C received a 0.9% Sodium Chloride Solution.The heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2) level of 3 groups were observed and recorded before and after anesthesia, intraoperative and postoperative.The propofol dosage and awake time of 3 groups were recorded, respectively. At the same time, pain degree was measured by using visual analogue scoring system (VAS).The incidence of adverse reaction were observed after operation.Result:After anesthesia, the patients in the B group SPO2 was significantly lower than that of A group and C group, the difference was statistically significant (P<0.05).The patients in the B group of propofol dosage is lower than that of A group and C group (P<0.05).The patients in the A group VAS were lower than those of B group and C group (P<0.05).Hypoxemia in patients in the B group were higher than A group and C group(P<0.05).Conclusion:Dexmedetomidine for elderly total hip replacement, sedative effect significantly, the respiratory inhibition is lighter and less adverse reaction.
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