Effects of dexmedetomidine combined with intraspinal anesthesia on perioperative brain injury, stress hormones and t lymphocyte subsets in elderly patients undergoing hip replacement

摘要

Objective: To investigate the effect of dexmedetomidin combined with intraspinal anesthesia on perioperative brain injury, stress hormone and T lymphocyte subsets in elderly patients undergoing hip replacement. Methods: A total of 106 elderly patients undergoing hip replacement were randomly divided into the observation group and the control group, 53 cases in each group. All patients received intraspinal anesthesia, and the observation group was given dexmedetomidine assisted anesthesia. The detection results of perioperative jugular bulb venous oxygen saturation (SjvO 2 ), jugular oxygen content (CjvO 2 ), cerebral arterial-venous oxygen content difference (D (a-jv) O 2 ), cerebral oxygen extraction rate (CERO 2 ), cerebral arterial oxygen content (CaO 2 ), S-100β protein of internal jugular vein, norepinephrine (NE), adrenaline (E), cortisol (Cor) and T lymphocyte subsets were compared between the two groups. Results: The SjvO 2 , CjvO 2 and CaO 2 in the observation group at the time of 30 min in the operation and immediately after operation were significantly higher than those in the control group, while the D (a-jv) O 2 and CERO 2 were significantly lower than those in the control group. The S-100β protein at the time of 30 min in the operation in the observation group was significantly lower than that in the control group. The NE, E and Cor in the observation group at the time of 30 min in the operation and immediately after operation were significantly lower than those in the control group. The CD3+, CD4+, CD8+ and CD4+/CD8+ in the observation group at the time of immediately after operation and 24 h after operation were significantly higher than those in the control group. Conclusion: Dexmedetomidine combined with intraspinal anesthesia can reduce perioperative brain injury, relieve stress response and improve the immune function of the elderly patients with hip replacement.