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Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery

BACKGROUND: A femoral neck fracture is a common and frequently reported issue in orthopedics, with a greater rate of incidence among the elderly. Due to their advanced age and the presence of some primary diseases, both anesthesia and surgery are increasingly difficult in elderly patients with a fem...

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Autores principales: Li, Jun-Qing, Yuan, Hao, Wang, Xiao-Qiang, Yang, Meng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294164/
https://www.ncbi.nlm.nih.gov/pubmed/37383121
http://dx.doi.org/10.12998/wjcc.v11.i16.3756
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author Li, Jun-Qing
Yuan, Hao
Wang, Xiao-Qiang
Yang, Meng
author_facet Li, Jun-Qing
Yuan, Hao
Wang, Xiao-Qiang
Yang, Meng
author_sort Li, Jun-Qing
collection PubMed
description BACKGROUND: A femoral neck fracture is a common and frequently reported issue in orthopedics, with a greater rate of incidence among the elderly. Due to their advanced age and the presence of some primary diseases, both anesthesia and surgery are increasingly difficult in elderly patients with a femoral neck fractures. In fact, general anesthesia can easily induce complications such as cognitive dysfunction, which is not conducive to postoperative recovery. AIM: To analyze the efficacy of dexmedetomidine in inducing anesthesia for elderly patients undergoing hip replacement surgery. METHODS: A total of 98 elderly patients undergoing hip replacement in our hospital from June 2020 to June 2021 were randomly divided into control group (49 cases) and observation group (49 cases). The control group was given general anesthesia, and the observation group was combined with dexmedetomidine for anesthesia on the basis of the control group. Both groups were observed until the patients were discharged. The vital signs, serum inflammatory factors and renal function indexes of the two groups were compared before, during and 6 h after operation. The postoperative recovery and adverse events of the two groups were statistically analyzed. RESULTS: Compared with the mean arterial pressure of the two groups, the intraoperative and postoperative 6 h was higher than that before the operation, the intraoperative was lower than the postoperative 6 h (P < 0.05); the blood oxygen saturation of the two groups was higher than that before operation and 6 h after operation, and the observation group was higher than the control group 6 h after operation (P < 0.05). The heart rate of the two groups was lower during and 6 h after operation than that before operation, and higher at 6 h after operation than that during operation (P < 0.05). The levels of serum C-reactive protein, tumor necrosis factor-α, interleukin-1β and kidney injury molecule-1 in the two groups were higher during operation and 6 h after operation than those before operation (P < 0.05). The level of serum urea nitrogen in the two groups was higher than that before operation, and that in the observation group was lower than that in the control group (P < 0.05). During hospitalization, the first time of getting out of bed, recovery time of grade II muscle strength, recovery time of grade III muscle strength and hospitalization time in the observation group were shorter than those in the control group (P < 0.05). CONCLUSION: Dexmedetomidine can effectively improve the vital signs of elderly patients undergoing hip replacement surgery, reduce the body's inflammatory response and renal function damage, and promote postoperative recovery. Meanwhile, dexmedetomidine showcased a good safety profile and a good anesthetic outcome.
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spelling pubmed-102941642023-06-28 Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery Li, Jun-Qing Yuan, Hao Wang, Xiao-Qiang Yang, Meng World J Clin Cases Retrospective Study BACKGROUND: A femoral neck fracture is a common and frequently reported issue in orthopedics, with a greater rate of incidence among the elderly. Due to their advanced age and the presence of some primary diseases, both anesthesia and surgery are increasingly difficult in elderly patients with a femoral neck fractures. In fact, general anesthesia can easily induce complications such as cognitive dysfunction, which is not conducive to postoperative recovery. AIM: To analyze the efficacy of dexmedetomidine in inducing anesthesia for elderly patients undergoing hip replacement surgery. METHODS: A total of 98 elderly patients undergoing hip replacement in our hospital from June 2020 to June 2021 were randomly divided into control group (49 cases) and observation group (49 cases). The control group was given general anesthesia, and the observation group was combined with dexmedetomidine for anesthesia on the basis of the control group. Both groups were observed until the patients were discharged. The vital signs, serum inflammatory factors and renal function indexes of the two groups were compared before, during and 6 h after operation. The postoperative recovery and adverse events of the two groups were statistically analyzed. RESULTS: Compared with the mean arterial pressure of the two groups, the intraoperative and postoperative 6 h was higher than that before the operation, the intraoperative was lower than the postoperative 6 h (P < 0.05); the blood oxygen saturation of the two groups was higher than that before operation and 6 h after operation, and the observation group was higher than the control group 6 h after operation (P < 0.05). The heart rate of the two groups was lower during and 6 h after operation than that before operation, and higher at 6 h after operation than that during operation (P < 0.05). The levels of serum C-reactive protein, tumor necrosis factor-α, interleukin-1β and kidney injury molecule-1 in the two groups were higher during operation and 6 h after operation than those before operation (P < 0.05). The level of serum urea nitrogen in the two groups was higher than that before operation, and that in the observation group was lower than that in the control group (P < 0.05). During hospitalization, the first time of getting out of bed, recovery time of grade II muscle strength, recovery time of grade III muscle strength and hospitalization time in the observation group were shorter than those in the control group (P < 0.05). CONCLUSION: Dexmedetomidine can effectively improve the vital signs of elderly patients undergoing hip replacement surgery, reduce the body's inflammatory response and renal function damage, and promote postoperative recovery. Meanwhile, dexmedetomidine showcased a good safety profile and a good anesthetic outcome. Baishideng Publishing Group Inc 2023-06-06 2023-06-06 /pmc/articles/PMC10294164/ /pubmed/37383121 http://dx.doi.org/10.12998/wjcc.v11.i16.3756 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Study
Li, Jun-Qing
Yuan, Hao
Wang, Xiao-Qiang
Yang, Meng
Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery
title Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery
title_full Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery
title_fullStr Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery
title_full_unstemmed Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery
title_short Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery
title_sort dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294164/
https://www.ncbi.nlm.nih.gov/pubmed/37383121
http://dx.doi.org/10.12998/wjcc.v11.i16.3756
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