Abstract:Objective To investigate the effects of application of dexmedetomidine-ketamine epidural sedation
in arthroscopic operation in elderly patients. Methods Altogether 60 cases of patients who underwent knee
arthroscopy in the hospital from January 2013 to January 2015 were selected as research subjects and assessed
as Grade I or II in line with ASA classification standards. According to random number table method, all these
patients were divided into Observation Group and Control Group with 30 cases in each group. Two groups of
patients accepted epidural anesthesia. Observation Group was given dexmedetomidine ketamine intravenous
anesthesia, while Control Group was given target-controlled infusion of propofol and intravenous fentanyl
combined anesthesia. Indicators such as OAA/S (The Observer’ Assessment of Alertness/Sedation Scale)
score, bispectral index (BIS), blood oxygen saturation (SpO2), mean arterial pressure (MAP), heart rate (HR)
and blood pressure (BP) were observed, and induction time, recovery time and adverse reaction conditions
were recorded. Satisfaction survey of operators and patients were conducted after the surgery. Results Patients
in Observation Group had stable breathing during the operation with average SpO2 higher than 96%. Partial
pressure of end-tidal carbon dioxide was normal. A total of 21 cases in Control Group had SpO2 less than
90%; 11 patients had respiratory pause and needed to be placed through the airway and (or) assisted with
ventilation. The differences between the two groups were statistically significant (P<0.05). Hemodynamics in
Observation Group was more stable than that in Control Group. However, when the BIS≤60, the heart rate
decreased significantly. The induction time and recovery time of Observation Group were longer than those
of Control Group (P<0.05). Patients and operators of the two groups had similar satisfaction rate to narcotic
effects. Conclusion Dexmedetomidine-ketamine epidural anesthesia is a safe method for elderly patients
with epidural anesthesia in arthroscopic surgery, with stable hemodynamic indicators and without significant
inhibition of respiration, which is worthy of clinical application.
张茹,张昊. 右美托咪定-氯胺酮复合麻醉在老年硬膜外关节镜手术中的研究[J]. 中国医疗设备, 2016, 31(6): 123-126.
ZHANG Ru, ZHANG Hao. Study on Application of Dexmedetomidine-ketamine Epidural
Anesthesia in Arthroscopic Operation in the Elderly. China Medical Devices, 2016, 31(6): 123-126.