艾司氯胺酮和右美托咪定麻醉用于老年下肢骨折患者手术中的效果比较

doi:10.3969/j.issn.1671-7171.2026.09.018

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Abstract 【Objective】To investigate the effects of esketamine and dexmedetomidine (Dex) anesthesia in elderly patients undergoing lower limb fracture surgery. 【Methods】 A total of 90 elderly patients with lower limb fractures admitted to Taikang County People's Hospital from January 2021 to January 2023 were randomly divided into an observation group (receiving esketamine anesthesia) and a control group (receiving Dex anesthesia), with 45 patients in each group. The anesthetic effects, perioperative indicators, and incidence of adverse reactions were compared between the two groups. Heart rate (HR) and mean arterial pressure (MAP) were recorded before anesthesia (T₀), 5 min after anesthesia (T₁), 30 min after anesthesia (T₂), and at the end of surgery (T₃). Pain status [assessed by the Visual Analogue Scale (VAS)] and cognitive function [assessed by the Mini-Mental State Examination (MMSE) score] were evaluated before and after surgery. 【Results】There were no statistically significant differences between the two groups in the excellent and good anesthesia rate, operation time, or anesthesia duration (all P>0.05). The recovery time and post-anesthesia care unit (PACU) stay time in the observation group were shorter than those in the control group (P<0.05). No significant differences were observed in HR or MAP between the two groups at T₀ and T₁ (all P>0.05). In the observation group, HR and MAP at T₂ and T₃ showed no significant differences compared with those at T₀ and T₁ (P>0.05). In the control group, HR and MAP at T₂ and T₃ were lower than those at T₀ and T₁ (P>0.05), while HR and MAP at T₂ and T₃ in the observation group were higher than those in the control group (P<0.05). After treatment, VAS scores in both groups were significantly lower than those before treatment (P<0.05), but there was no significant difference between the groups (P>0.05). The MMSE score in the observation group after treatment was higher than that before treatment. Also, the MMSE score in the observation group after treatment was higher than that in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 Both esketamine and Dex anesthesia are safe and effective for elderly patients undergoing lower limb fracture surgery. However, esketamine anesthesia is beneficial for postoperative recovery, provides more stable hemodynamics, and may contribute to improving cognitive function.

Key words： Esketamine Dexmedetomidine Lower Limb Fractures Aged

Received: 15 December 2023

PACS:

R683.42

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	HENG Lei
	WANG Han
	LI Jinjin

Cite this article:

HENG Lei,WANG Han,LI Jinjin. Comparison of the Effects of Esketamine and Dexmedetomidine Anesthesia in Elderly Patients Undergoing Lower Limb Fracture Surgery[J]. JOURNAL OF CLINICAL RESEARCH, 2026, 43(9): 1474-1477.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2026.09.018 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2026/V43/I9/1474

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