|
|
Effects of Dexmedetomidine Combined with Ultrasound-Guided Nerve Block Anesthesia on Diabetic Foot Gangrene Surgery |
ZHENG Minghui, SHI Tao |
Hanzhong Central Hospital, Hanzhong Shaanxi 723000 |
|
|
Abstract 【Objective】To explore the effects of dexmedetomidine (Dex) combined with ultrasound-guided nerve block anesthesia on diabetic foot gangrene surgery. 【Methods】Eighty patients undergoing diabetic foot gangrene surgery were randomly divided into two groups, with 40 patients in each. The control group underwent ultrasound-guided nerve block anesthesia, while the observation group received anesthesia with Dex combined on the basis of the control group. The sensory and motor nerve block time of the two groups was compared, along with hemodynamic changes [heart rate (HR), blood oxygen saturation (SpO2)] at different time points before and after anesthesia. Serum immune function indicators [CD4+, CD8+, CD4+/CD8+] before anesthesia and after surgery were measured, and the incidence of adverse reactions was recorded as well. 【Results】The onset and completion time of sensory and motor blockade in the observation group were shorter than those in the control group (P<0.05); the duration of sensory and motor blockade in the observation group was longer than that in the control group (P<0.05). The HR after anesthesia in the observation group was significantly higher than that in the control group (P<0.05); the HR at the start of surgery in the observation group was lower than after anesthesia in the same group (P<0.05); the HR after anesthesia in the control group was significantly lower than before anesthesia in the same group (P<0.05). The levels of CD4+ and CD4+/CD8+ after surgery in the control group were significantly lower than before anesthesia in the same group (P<0.05); the levels of CD4+ and CD4+/CD8+ after surgery in the observation group were significantly higher than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】The use of Dex combined with ultrasound-guided nerve block anesthesia for diabetic foot gangrene surgery significantly improves the anesthetic effect, effectively prolongs the nerve block time, maintains stable hemodynamic levels, and does not increase adverse reactions.
|
Received: 20 September 2022
|
|
|
|
|
[1] 闫振成. 糖尿病足的诊治进展[J].重庆医科大学学报,2017,42(3):263-267. [2] 阮雁捷,郭冠军,冯玉,等. 糖尿病手术患者麻醉方式对术后感染与血流动力学及血糖的影响[J].中华医院感染学杂志,2017,27(17):3933-3935. [3] 胡晓云,赵斌江,苏跃,等.右美托咪定区域麻醉镇静对糖尿病老年患者术后认知功能的影响[J].中华麻醉学杂志,2017,37(11):1296-1299. [4] ELGZYRI T, APELQVIST J, LINDHOLM E, et al. Healing below the ankle is possible in patients with diabetes mellitus and a forefoot gangrene[J].SAGE Open Med,2021,9:20503121211029180. [5] 孙婷婷,吴畏. 不同麻醉方式对伴糖尿病手术患者术后感染与血流动力学及血糖指标的影响研究[J].中华医院感染学杂志,2019,29(9):1359-1362. [6] AO C B, WU P L, SHAO L, et al. Clinical effect of ultrasound-guided nerve block and dexmedetomidine anesthesia on lower extremity operative fracture reduction[J].World J Clin Cases,2022,10(13):4064-4071. [7] 王武,吴绍芳,郑旺福.右美托咪定对周围神经阻滞下行下肢手术患者止血带反应的影响[J].中华麻醉学杂志,2018,38(6):652-655. [8] 于范亭.超声引导下肢神经阻滞复合右美托咪定持续泵注在老年髋关节置换术中镇痛效果与对应激水平呼吸循环的影响[J].河北医药,2019,41(1):66-70. [9] 李乐, 赵博, 卢锡华. 手术治疗糖尿病足患者下肢神经阻滞中右美托咪定复合罗哌卡因应用观察[J].山东医药, 2019, 59(15):55-57. [10] 马婕妤,宋琼. 氟比洛芬酯联合地佐辛超前镇痛对宫颈癌患者术后疼痛及免疫功能的影响[J].中国老年学杂志,2018,38(13):3143-3146. [11] 张伟,李元海,蔡宁. 右美托咪定复合罗哌卡因对老年下肢手术患者缺血再灌注损伤的影响[J].中国老年学杂志,2020,40(9):1889-1892. [12] 蔡强, 高美玲, 王斌,等. 右美托咪定联合超声引导下神经阻滞对腹股沟区手术患者血流动力学,免疫功能及皮质醇水平的影响[J].海南医学院学报, 2018, 24(16):1471-1474. |
|
|
|