Clinical study on dexmedetomidine combined with hypobaric lumbar anesthesia for elderly patients with hip replacement

摘要

Objective: To study the effects of dexmedetomidine combined with hypobaric lumbar anesthesia on pain mediator secretion as well as inflammatory response and stress response activation in elderly patients with hip replacement. Methods: Elderly patients who were ＞ 70 years old and underwent hip replacement in Hancheng People's Hospital between March 2015 and June 2017 were chosen and randomly divided into the experimental group who accepted dexmedetomidine combined with hypobaric lumbar anesthesia and the control group who accepted hypobaric lumbar anesthesia alone. The levels of pain mediators and stress mediators in serum as well as the expression of inflammatory molecules in peripheral blood were measured before surgery, the same day after surgery and 3 d after surgery. Results: Compared with those of same group before surgery, CGRP, β-EP, SP, BK, TNF-α, ACTH, F-C, F-Ins, NE and MDA levels in serum as well as NLRP3, Caspase-1, TLR4 and NF-κB mRNA expression in peripheral blood of both groups significantly increased the same day after surgery and 3 d after surgery, and CGRP, β-EP, SP, BK, TNF-α, ACTH, F-C, F-Ins, NE and MDA levels in serum as well as NLRP3, Caspase-1, TLR4 and NF-κB mRNA expression in peripheral blood of experimental group the same day after surgery and 3 d after surgery were significantly lower than those of control group. Conclusion: Dexmedetomidine combined with hypobaric lumbar anesthesia for hip replacement in the elderly can reduce the secretion of pain mediators and relieve the inflammatory response and stress response.