Sedative effect and safety analysis of different concentrations of dexmedetomidine combined with remifentanil assisted local infiltration anesthesia on elderly patients with inguinal hernia repair

doi:10.3877/cma.j.issn.1674-392X.2020.05.016

Abstract

Abstract:

Objective

To investigate the sedative effect and safety of different concentrations of dexmedetomidine combined with remifentanil assisted local infiltration anesthesia for inguinal hernia repair in elderly patients.

Methods

Between January 2019 and October 2019, ninty elderly inguinal hernia patients undergoing laparoscopic inguinal hernia repair under local infiltration anesthesia in Chongqing Yongchuan children's hospital were randomly divided into the control group (n=45 cases) and the observation group (n=45 cases). The control group was given high dose [0.6μg/(kg·h)]) dexmedetomidine hydrochloride injection combined with remifentanil hydrochloride for injection to assist local infiltration anesthesia. The observation group was given low dose [0.3μg/ (kg·h)] dexmedetomidine hydrochloride injection combined with remifentanil hydrochloride for injection to assist local infiltration anesthesia. The alert/sedation (OAA/S) scores and hemodynamic indexes of the two groups before (T1), 10 min after medication (T2), 20 min after medication (T3), 30 min after medication (T4) and patients after waking (T5) were compared. The pain degree during local anesthesia, skin incision, operation and skin suture and the safety during treatment were observed.

Results

The OAA/S scores in the two groups showed a decreasing trend at T1-T4, and increased at T5 (P<0.05). The mean arterial pressure (MAP) and heart rate (HR) in the observation group showed a decreasing trend at T1-T4, while MAP and HR increased at T5 (P<0.05). At T3 and T4, OAA/S scores, MAP and HR in the observation group were lower than those in the control group (P<0.05). The visual analogue scale (VAS) score in the observation group was lower than that in the control group at all time points (local anesthesia, skin incision, surgery and skin suture) (P<0.05). The incidence rates of agitation and malignant vomiting in the observation group were 2.22% and 4.44%, which were lower than those in the control group (17.78% and 17.78%, P<0.05).

Conclusion

Low dose dexmedetomidine combined with remifentanil assisted local infiltration anesthesia can significantly improve the hemodynamics of elderly patients with inguinal hernia, with significant sedative and analgesic effects and high safety, and it is worthy of promotion.

Key words: Hernia, inguinal, Dexmedetomidine, Remifentanil, Local infiltration anesthesia, Inguinal hernia repair, Calm down, Analgesia, Safety

Yuxin Liu, Hong Chen, Dong Yan. Sedative effect and safety analysis of different concentrations of dexmedetomidine combined with remifentanil assisted local infiltration anesthesia on elderly patients with inguinal hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(05): 527-531.

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References 20

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组别	例数	T1	T2	T3	T4	T5	F值	P值
观察组	45	5.00±0.00	4.19±1.25	3.11±0.96^*	2.42±0.58^*	4.81±0.36^*	9.056	<0.05
对照组	45	5.00±0.00	4.24±1.07	3.74±1.08	3.16±0.72	4.88±0.11	11.237	<0.05

组别	例数	T1	T2	T3	T4	T5	F值	P值
观察组	45	5.00±0.00	4.19±1.25	3.11±0.96^*	2.42±0.58^*	4.81±0.36^*	9.056	<0.05
对照组	45	5.00±0.00	4.24±1.07	3.74±1.08	3.16±0.72	4.88±0.11	11.237	<0.05

组别	例数		T1	T2	T3	T4	T5	F值	P值
观察组	45	MAP(mmHg)	85.12±8.75	85.16±10.02	74.37±9.24^*	70.26±8.19^*	80.81±8.04	3.962	<0.05
对照组	45		84.29±9.63	88.41±9.18	86.19±11.35	85.20±13.74	82.33±9.61	0.961	>0.05
观察组	45	HR(次/min)	78.09±9.53	80.18±9.26	72.51±8.10^*	69.74±7.58^*	72.62±8.04	4.157	<0.05
对照组	45		77.95±8.91	84.06±10.08	88.59±9.20	88.38±9.15	73.12±7.89	1.052	>0.05

组别	例数		T1	T2	T3	T4	T5	F值	P值
观察组	45	MAP(mmHg)	85.12±8.75	85.16±10.02	74.37±9.24^*	70.26±8.19^*	80.81±8.04	3.962	<0.05
对照组	45		84.29±9.63	88.41±9.18	86.19±11.35	85.20±13.74	82.33±9.61	0.961	>0.05
观察组	45	HR(次/min)	78.09±9.53	80.18±9.26	72.51±8.10^*	69.74±7.58^*	72.62±8.04	4.157	<0.05
对照组	45		77.95±8.91	84.06±10.08	88.59±9.20	88.38±9.15	73.12±7.89	1.052	>0.05

组别	例数	局麻时	切皮时	手术中	缝皮时	F值	P值
观察组	45	0.94±0.59^*	1.50±0.38^*	1.56±0.22^*	1.54±0.18^*	1.191	0.074
对照组	45	3.06±0.74	3.37±0.71	3.18±0.40	2.26±0.25	0.887	0.105

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