Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2023; 11(16): 3756-3764
Published online Jun 6, 2023. doi: 10.12998/wjcc.v11.i16.3756
Dexmedetomidine-induced anesthesia in elderly patients undergoing hip replacement surgery
Jun-Qing Li, Hao Yuan, Xiao-Qiang Wang, Meng Yang
Jun-Qing Li, Hao Yuan, Xiao-Qiang Wang, Meng Yang, Department of Anesthesiology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, Anhui Province, China
Author contributions: Li JQ and Yuan H proposed concepts for this study; Wang XQ and Yang M collected data; Li JQ, Yuan H, and Wang XQ contributed to formal analysis; Li JQ and Yang M contributed to the survey; Li JQ, Yuan H, and Yang M contributed to this method; Li JQ, Yuan H, Wang XQ, and Yang M supervised the study; Li JQ validated this study; Yuan H and Wang XQ contributed to the visualization of research; Li JQ and Yuan H initially drafted this manuscript; Li JQ, Yuan H, Wang XQ, and Yang M reviewed and edited the manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Committee of the First Hospital Affiliated to Anhui Medical University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that there are no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Qing Li, MD, Attending Doctor, Department of Anesthesiology, Fuyang Hospital of Anhui Medical University, No. 99 Huangshan Road, Fuyang Hefei Modern Industrial Park, Yingzhou District, Fuyang 236000, Anhui Province, China. lijunqing005@126.com
Received: March 13, 2023
Peer-review started: March 13, 2023
First decision: March 28, 2023
Revised: April 13, 2023
Accepted: April 24, 2023
Article in press: April 24, 2023
Published online: June 6, 2023
Processing time: 81 Days and 8.2 Hours
Abstract
BACKGROUND

A femoral neck fracture is a common and frequently reported issue in orthopedics, with a greater rate of incidence among the elderly. Due to their advanced age and the presence of some primary diseases, both anesthesia and surgery are increasingly difficult in elderly patients with a femoral neck fractures. In fact, general anesthesia can easily induce complications such as cognitive dysfunction, which is not conducive to postoperative recovery.

AIM

To analyze the efficacy of dexmedetomidine in inducing anesthesia for elderly patients undergoing hip replacement surgery.

METHODS

A total of 98 elderly patients undergoing hip replacement in our hospital from June 2020 to June 2021 were randomly divided into control group (49 cases) and observation group (49 cases). The control group was given general anesthesia, and the observation group was combined with dexmedetomidine for anesthesia on the basis of the control group. Both groups were observed until the patients were discharged. The vital signs, serum inflammatory factors and renal function indexes of the two groups were compared before, during and 6 h after operation. The postoperative recovery and adverse events of the two groups were statistically analyzed.

RESULTS

Compared with the mean arterial pressure of the two groups, the intraoperative and postoperative 6 h was higher than that before the operation, the intraoperative was lower than the postoperative 6 h (P < 0.05); the blood oxygen saturation of the two groups was higher than that before operation and 6 h after operation, and the observation group was higher than the control group 6 h after operation (P < 0.05). The heart rate of the two groups was lower during and 6 h after operation than that before operation, and higher at 6 h after operation than that during operation (P < 0.05). The levels of serum C-reactive protein, tumor necrosis factor-α, interleukin-1β and kidney injury molecule-1 in the two groups were higher during operation and 6 h after operation than those before operation (P < 0.05). The level of serum urea nitrogen in the two groups was higher than that before operation, and that in the observation group was lower than that in the control group (P < 0.05). During hospitalization, the first time of getting out of bed, recovery time of grade II muscle strength, recovery time of grade III muscle strength and hospitalization time in the observation group were shorter than those in the control group (P < 0.05).

CONCLUSION

Dexmedetomidine can effectively improve the vital signs of elderly patients undergoing hip replacement surgery, reduce the body's inflammatory response and renal function damage, and promote postoperative recovery. Meanwhile, dexmedetomidine showcased a good safety profile and a good anesthetic outcome.

Keywords: Hip replacement; Old age; Dexmedetomidine; Anesthetic effect; Vital signs

Core Tip: Dexmedetomidine is a type of drug that selectively activates the α2-adrenergic receptors. It stimulates the postsynaptic membrane receptors, inhibits sympathetic nerves, and effectively maintains the hemodynamic fluctuations in the body to achieve the desired sedative effects.