Observation of Anesthetic Effect of Dexmedetomidine Combined With Intraspinal Anesthesia in Hip Arthroplasty and its Effect on Postoperative Delirium and Stress Response

ObjectiveTo observe the anesthetic effect of dexmedetomidine combined with spinal anesthesia in hip arthroplasty, and to analyze the effects of dexmedetomidine on postoperative stress response, incidence of delirium, immune function and inflammatory indicators.MethodsA total of 42 patients who under...

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Main Authors: Yading Shen, Chenyu Wang, Xiaoping Zhong, Yandan Wu, Xiaoxia He
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-07-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2022.928922/full
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author Yading Shen
Chenyu Wang
Xiaoping Zhong
Yandan Wu
Xiaoxia He
author_facet Yading Shen
Chenyu Wang
Xiaoping Zhong
Yandan Wu
Xiaoxia He
author_sort Yading Shen
collection DOAJ
description ObjectiveTo observe the anesthetic effect of dexmedetomidine combined with spinal anesthesia in hip arthroplasty, and to analyze the effects of dexmedetomidine on postoperative stress response, incidence of delirium, immune function and inflammatory indicators.MethodsA total of 42 patients who underwent hip replacement in our hospital from March 2020 to June 2021 were selected as the research subjects and randomly divided into the control group and the observation group, 21 cases in each group. The control group was given intraspinal anesthesia, and the observation group was given dexmedetomidine on this basis. The onset time and maintenance time of sensory and motor nerve block were recorded. Stress response indexes [cortisol (Cor), blood glucose (Glu), adrenaline (E), noadrenaline (NE)], T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+), inflammatory indexes [tumor necrosis factor -α (TNF-α) and interleukin-6 (IL-6)] were detected before and after operation, and the incidence of postoperative delirium in both groups was recorded.ResultsThe onset time of sensory nerve block and motor block in the observation group were lower than those in the control group, and the retention time of sensory nerve block and motor nerve block were higher than those in the control group (P < 0.05). After surgery, the levels of Cor, Glu, E and NE in the observation group were lower than those in the control group (P < 0.05). After surgery, the incidence of postoperative delirium in the observation group (4.79%) was lower than that in the control group (28.57%) (P < 0.05). After surgery, the levels of CD3+, CD4+, CD8+, and CD4+/CD8+ in the observation group were higher than those in the control group (P < 0.05). After surgery, the levels of TNF-α and IL-6 in the observation group were lower than those in the control group (P < 0.05).ConclusionThe combined use of dexmedetomidine and intraspinal anesthesia has good anesthesia effect in hip joint replacement, which can greatly reduce the stress response of patients, reduce the incidence of postoperative delirium, and effectively restore the immune function of patients, reduce the level of inflammatory response, and has high clinical application value.
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spelling doaj.art-c474b51a29244fc38285bb689dc94f7e2022-12-22T03:33:12ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-07-01910.3389/fsurg.2022.928922928922Observation of Anesthetic Effect of Dexmedetomidine Combined With Intraspinal Anesthesia in Hip Arthroplasty and its Effect on Postoperative Delirium and Stress ResponseYading Shen0Chenyu Wang1Xiaoping Zhong2Yandan Wu3Xiaoxia He4Department of Anesthesiology, Yiwu Central Hospital, Yiwu, ChinaDepartment of Anesthesiology, Yiwu Central Hospital, Yiwu, ChinaDepartment of Anesthesiology, Yiwu Central Hospital, Yiwu, ChinaDepartment of Anesthesiology, Yiwu Central Hospital, Yiwu, ChinaDepartment of Anesthesiology, Zhuji People's Hospital of Zhejiang Province, Zhuji, ChinaObjectiveTo observe the anesthetic effect of dexmedetomidine combined with spinal anesthesia in hip arthroplasty, and to analyze the effects of dexmedetomidine on postoperative stress response, incidence of delirium, immune function and inflammatory indicators.MethodsA total of 42 patients who underwent hip replacement in our hospital from March 2020 to June 2021 were selected as the research subjects and randomly divided into the control group and the observation group, 21 cases in each group. The control group was given intraspinal anesthesia, and the observation group was given dexmedetomidine on this basis. The onset time and maintenance time of sensory and motor nerve block were recorded. Stress response indexes [cortisol (Cor), blood glucose (Glu), adrenaline (E), noadrenaline (NE)], T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+), inflammatory indexes [tumor necrosis factor -α (TNF-α) and interleukin-6 (IL-6)] were detected before and after operation, and the incidence of postoperative delirium in both groups was recorded.ResultsThe onset time of sensory nerve block and motor block in the observation group were lower than those in the control group, and the retention time of sensory nerve block and motor nerve block were higher than those in the control group (P < 0.05). After surgery, the levels of Cor, Glu, E and NE in the observation group were lower than those in the control group (P < 0.05). After surgery, the incidence of postoperative delirium in the observation group (4.79%) was lower than that in the control group (28.57%) (P < 0.05). After surgery, the levels of CD3+, CD4+, CD8+, and CD4+/CD8+ in the observation group were higher than those in the control group (P < 0.05). After surgery, the levels of TNF-α and IL-6 in the observation group were lower than those in the control group (P < 0.05).ConclusionThe combined use of dexmedetomidine and intraspinal anesthesia has good anesthesia effect in hip joint replacement, which can greatly reduce the stress response of patients, reduce the incidence of postoperative delirium, and effectively restore the immune function of patients, reduce the level of inflammatory response, and has high clinical application value.https://www.frontiersin.org/articles/10.3389/fsurg.2022.928922/fullhip replacementdexmedetomidineintraspinal anesthesiaanesthetic effectsstress responsedelirium
spellingShingle Yading Shen
Chenyu Wang
Xiaoping Zhong
Yandan Wu
Xiaoxia He
Observation of Anesthetic Effect of Dexmedetomidine Combined With Intraspinal Anesthesia in Hip Arthroplasty and its Effect on Postoperative Delirium and Stress Response
Frontiers in Surgery
hip replacement
dexmedetomidine
intraspinal anesthesia
anesthetic effects
stress response
delirium
title Observation of Anesthetic Effect of Dexmedetomidine Combined With Intraspinal Anesthesia in Hip Arthroplasty and its Effect on Postoperative Delirium and Stress Response
title_full Observation of Anesthetic Effect of Dexmedetomidine Combined With Intraspinal Anesthesia in Hip Arthroplasty and its Effect on Postoperative Delirium and Stress Response
title_fullStr Observation of Anesthetic Effect of Dexmedetomidine Combined With Intraspinal Anesthesia in Hip Arthroplasty and its Effect on Postoperative Delirium and Stress Response
title_full_unstemmed Observation of Anesthetic Effect of Dexmedetomidine Combined With Intraspinal Anesthesia in Hip Arthroplasty and its Effect on Postoperative Delirium and Stress Response
title_short Observation of Anesthetic Effect of Dexmedetomidine Combined With Intraspinal Anesthesia in Hip Arthroplasty and its Effect on Postoperative Delirium and Stress Response
title_sort observation of anesthetic effect of dexmedetomidine combined with intraspinal anesthesia in hip arthroplasty and its effect on postoperative delirium and stress response
topic hip replacement
dexmedetomidine
intraspinal anesthesia
anesthetic effects
stress response
delirium
url https://www.frontiersin.org/articles/10.3389/fsurg.2022.928922/full
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