Effect of dexmedetomidine combined with esketamine on stress reaction of elderly patients with percutaneous vertebroplasty

LIU Geng; ZHANG Zhuangyun; HU Jian; CHEN Chen; BIAN Qingming

doi:10.7619/jcmp.20222679

Journal of Clinical Medicine in Practice > 2023 > 27(1): 79-83, 91. > DOI: 10.7619/jcmp.20222679

LIU Geng, ZHANG Zhuangyun, HU Jian, CHEN Chen, BIAN Qingming. Effect of dexmedetomidine combined with esketamine on stress reaction of elderly patients with percutaneous vertebroplasty[J]. Journal of Clinical Medicine in Practice, 2023, 27(1): 79-83, 91. DOI: 10.7619/jcmp.20222679

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Effect of dexmedetomidine combined with esketamine on stress reaction of elderly patients with percutaneous vertebroplasty

1.
Department of Anesthesiology, Lishui District People's Hospital of Nanjing City in Jiangsu Province, Lishui Branch of Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu, 211200
2.
Department of Anesthesiology, Jiangsu Cancer Hospital, Cancer Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210009

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Received Date: August 28, 2022
Available Online: February 01, 2023

Graphical Abstract

Abstract

Abstract

Objective
To observe the effect of dexmedetomidine combined with sub-anesthetic esketamine on stress reaction of elderly patients with percutaneous vertebroplasty.
Methods
A total of 120 elderly patients with elective percutaneous vertebroplasty were selected as research objects, and they were randomly divided into control group, dexmedetomidine group, esketamine group and combined group, with 30 cases in each group. In the dexmedetomidine group and the combined group, 0.5 μg/kg dexmedetomidine was pumped intravenously at 10 min before local anesthesia, and then 0.25 μg/(kg·h) dexmedetomidine was pumped continuously for anesthesia maintenance; in the esketamine group and the combined group, 0.25 mg/kg esketamine was used; before operation, the patients in four groups were given 1% lidocaine hydrochloride for local infiltration anesthesia. The vital signs, score of Visual Analogue Scale (VAS) for pain and Ramsay score for sedation were recorded at the time points of 5 minutes after entering the operating room (T₀), the beginning of surgery (T₁), the puncture needle reaching the vertebral body (T₂), injection of bone cement (T₃), the end of surgery (T₄) and before returning to the ward (T₅); the levels of plasma cortisol (Cor), blood glucose (Glu), plasma epinephrine (E) and norepinephrine (NE) were measured at T₀, T₁, T₃ and T₄.
Results
Compared with T₀ and the dexmedetomidine group, the mean arterial pressure (MAP) and heart rate (HR) at T₁ to T₃ in the control group were significantly higher (P < 0.05); compared with the control group, the MAP and HR at T₁ to T₃ in the dexmedetomidine group, the esketamine group and the combined group decreased significantly (P < 0.05). Compared with T₀, the VAS scores at T₂ to T₃ in the control group increased significantly, while the VAS scores at T₂ to T₅ in the dexmedetomidine group and the esketamine group as well as at T₁ to T₅ in the combined group decreased significantly (P < 0.05); compared with T₀ and the control group, the Ramsay scores at T₁ to T₅ in the dexmedetomidine group, the esketamine group and the combined group were significantly higher (P < 0.05). Compared with T₀, the levels of plasma Cor and Glu at T₁, T₃ and T₄ in the control group, the dexmedetomidine group and the esketamine group were significantly higher (P < 0.05); compared with the control group, the levels of plasma Cor and Glu at T₁, T₃ and T₄ in the dexmedetomidine group, the esketamine group and the combined group were significantly lower (P < 0.05); compared with T₀, the levels of plasma E and NE at T₁, T₃ and T₄ in the control group as well as at T₁ and T₃ in the dexmedetomidine group and the esketamine group were significantly higher (P < 0.05); compared with the control group, the levels of plasma E and NE at T₁, T₃ and T₄ in the dexmedetomidine group, the esketamine group and the combined group were significantly lower in abore indicators (P < 0.05).
Conclusion
The sedative and analgesic effect of dexmedetomidine combined with sub-anesthetic esketamine is definite in elderly patients with percutaneous vertebroplasty, which can alleviate the stress reaction and promote rapid recovery after operation.
- dexmedetomidine,
- esketamine,
- percutaneous vertebroplasty,
- anesthetic effect,
- stress reaction

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References (14)

References

[1]	陈启才, 卢翠萍. 经皮穿刺椎体成形术联合体位复位治疗老年胸腰椎压缩性骨折患者的临床效果[J]. 福建医药杂志, 2022, 44(1): 49-51. https://www.cnki.com.cn/Article/CJFDTOTAL-FJYY202201016.htm
[2]	MCPHERSON C, LIVISKIE C J, ZELLER B, et al. The impact of dexmedetomidine initiation on cardiovascular status and oxygenation in critically ill neonates[J]. Pediatr Cardiol, 2022, 43(6): 1319-1326. doi: 10.1007/s00246-022-02854-8
[3]	周萍, 朱玉梅, 张维清, 等. 亚麻醉剂量艾司氯胺酮联合舒芬太尼用于老年髋关节置换术患者的临床观察[J]. 实用药物与临床, 2022, 25(2): 159-163. https://www.cnki.com.cn/Article/CJFDTOTAL-LYLC202202010.htm
[4]	彭伟娇, 胡杏娟, 赖洁珊, 等. 康复护理干预对老年骨质疏松性骨折患者术后疼痛及生活质量的影响[J]. 齐鲁护理杂志, 2020, 26(2): 65-67. doi: 10.3969/j.issn.1006-7256.2020.02.021
[5]	李红丽. 不同麻醉方式对老年妇科腹腔镜手术患者麻醉效果及术后认知功能的影响[J]. 河南外科学杂志, 2022, 28(3): 159-161. https://www.cnki.com.cn/Article/CJFDTOTAL-HLWK202203061.htm
[6]	DING M Y, CHEN Y, LUAN H F, et al. Dexmedetomidine reduces inflammation in traumatic brain injury by regulating the inflammatory responses of macrophages and splenocytes[J]. Exp Ther Med, 2019, 18(3): 2323-2331.
[7]	VARSHNEY A, PRABHU M, PERIYADKA B, et al. Transversus abdominis plane (TAP) block with levobupivacaine versus levobupivacaine with dexmedetomidine for postoperative analgesia following cesarean delivery[J]. J Anaesthesiol Clin Pharmacol, 2019, 35(2): 161-164. doi: 10.4103/joacp.JOACP_372_17
[8]	康艺涵, 朱尤壮, 秦上媛, 等. 艾司氯胺酮的研究进展[J]. 中国医师进修杂志, 2021, 44(5): 470-476. doi: 10.3760/cma.j.cn115455-20200706-00845
[9]	沈途, 吴巧玲. 艾司氯胺酮联合右美托咪定在老年患者经皮椎体成形术中的应用[J]. 锦州医科大学学报, 2022, 43(2): 28-31. https://www.cnki.com.cn/Article/CJFDTOTAL-JZYX202202006.htm
[10]	任海强, 李雷, 杨旺燕, 等. 小剂量艾司氯胺酮联合右美托咪定在老年患者椎体成形术麻醉中的应用[J]. 基础医学与临床, 2022, 42(6): 950-954.
[11]	王中玉, 李娟, 王安琪, 等. 亚麻醉剂量艾司氯胺酮对行膝关节置换术老年患者麻醉诱导期间血流动力学和应激反应的影响[J]. 中华实用诊断与治疗杂志, 2022, 36(1): 88-92. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD202201021.htm
[12]	李鑫, 张东. 加速康复外科对中老年股骨粗隆间骨折髓内钉内固定患者近期疗效与应激反应的影响[J]. 中华老年多器官疾病杂志, 2020, 19(11): 856-860. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLQG202011016.htm
[13]	张望. 无痛分娩对妊娠期高血压初产妇皮质醇、胰岛素和血糖水平的影响[J]. 甘肃医药, 2021, 40(9): 822-824. https://www.cnki.com.cn/Article/CJFDTOTAL-GSYY202109021.htm
[14]	李红, 吴军娜, 刘叶, 等. 右美托咪定对不同年龄妇科腹腔镜手术患者围术期应激反应的影响[J]. 河北医科大学学报, 2019, 40(10): 1201-1206. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX201910021.htm

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Effect of dexmedetomidine combined with esketamine on stress reaction of elderly patients with percutaneous vertebroplasty

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