| Objective:To evaluate the effects and adverse reactions of dexmedetomidine on sedation on the postoperative sleep quality of elderly patients with mild somnipathy undergoing spinal anesthesia.Methods:1.The case selection:60 elderly patients with mild somnipathy from Dalian Central Hospital in 2015.6-2016.6 undergoing spinal anesthesia on saphenous vein ligation and stripping elective surgery were selected and randomly divided into two groups(the random number table):dexmedetomidine group(n=30)and control group(n=30).2.sedate method:When lumbar epidural anesthesia keep stable,dexmedetomidine group began intravenous infusion 0.5μg/kg dexmedetomidine in ten minutes,then continuous intravenous infusion with dexmedetomidine 0.2 μg kg-1·h-1,control group was intravenous infusion with 0.9%NS.3.General and Pathological data:① Physical and surgery-related data(baseline data)including age,gender,ASA,BMI,operation time,infused crystalloid fluid;②Adverse reactions including the incidence of slow heart rate,hypotension,respiratory depression,nausea and vomiting during the operation;③the VAS score of the 1th,3th day of postoperation;④the AIS score of the 1th,3th day of postoperation and the 1th day prior to the operation;⑤the PSQI score of the 1th month prior to the operation and the 1th month of postoperation.4.Statistical methods:SPSS20.0 software was used for all the statistical analysis,measurement data were descriptived by mean±variance and compared with t-test or rank sum test,count data were compared with chi-square test of rank sum test,P<0.05 was significant difference.Results:1.The Baseline data:A total 59 cases with 30 dexmedetomidine group and 29 in control group were actually recruited and involved in our study,including 29 males(49.2%)and 30(50.8%)females.There were no significant differences(P>0.05)between the two groups in age(P=0.704),gender(P=0.514),ASA(P=0.344),BMI(P=0.776),operation time(P=0.558),infused crystalloid fluid(P=0.257).2.Comparison of VAS score:there was no significant difference between the two groups in VAS score of the 1st(P=0.670)and 3rd(P=0.775)postoperative day(P>0.05).3.Comparison of AIS score:there ware no significant difference between the two groups in AIS score at the 1th day prior to the operation(P=0.719>0.05);AIS score in dexmedetomidine group of the 1st(P=0.000<0.05)and 3rd(P=0.006<0.05)postoperative day were significantly higher than the 1st day prior to the operation;AIS score in control group of the 1st(P=0.000<0.05)and 3rd(P=0.000<0.05)postoperative day were significantly higher than the 1st day prior to the operation.compared with the control group,AIS score of the 1st(P=0.015<0.05)and 3rd(P=0.018<0.05)postoperative day in dexmedetomidine group decreased significantly.4.Comparison of PSQI score:there was no significant difference between the two groups in PSQI score at the 1 month prior to the operation(P=0.16>0.05);the PSQI score of the 1 postoperative month was decreased significantly compared with the 1 month before operation in dexmedetomidine group(P=0.000<0.05).There was no significant difference between the 1 postoperative month and the 1 month before operation in control group(P=0.861>0.05).5.Adverse reactions during the operation:There was no significant difference in the incidence of hypotension(P=0.953>0.05)and respiratory depression(P=0.305>0.05)during the operation;the incidence of Bradrhythmia in dexmedetomidine group was significantly higher compared with the control group(P=0.01<0.05);the incidence of nausea and vomiting in dexmedetomidine group was significantly lower compared with the control group(P=0.042<0.05);Conclusion:Dexmedetomidine given spinal anesthesia assist sedation to elderly patients with mild somnipathy can improve short-term and long-term postoperative sleep at the same time to a certain extent,worth to be popularized,which is really beneficial to postoperative rehabilitation. |
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