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| Effects of Dexmedetomidine on Restlessness Stress Response and Immune Function in Elderly Patients with Lower Limb Fractures During Recovery from General Anesthesia |
| LI Songlin, LI Xian, ZENG Bin, et al |
| The First People's Hospital of Chenzhou City, Hunan Chenzhou 423000,China |
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Abstract Objective: To explore the effect of general anesthesia of dexmedetomidine used in elderly patients with lower limb fractures on restlessness, stress response and immune function during the recovery period. Methods: A total of 128 elderly patients who underwent lower limb fracture surgery in our hospital from January 2020 to December 2020 were selected. According to different anesthetics, 67 patients who were given sodium chloride solution were included in the control group, and 61 patients who were given dexmedetomidine were included in the study group. The Riker Sedation and Restlessness Score (RSAS) was used to assess the agitation of the two groups of patients during the recovery period, and to compare the two groups of stress responses [norepinephrine (NE), epinephrine (E) and cortisol (Cor)], immune function [CD4+, CD4+/CD8+] changes and complications during recovery from anesthesia. Results: The RAS score of the study group was significantly lower than that of the control group at 30 min (T1), 60 min (T2) and the end of the operation (T3) after treatment (P<0.05). E, NE, and Cor increased at T1, T2, and T3 in the two groups compared with preoperative (T0) (P<0.05), but the E, NE, and Cor in the study group were significantly lower than those in the control group at T2, T3 (P<0.05). The levels of CD4+ and CD4+/CD8+ at the end of anesthesia, 24h after operation, and 48h after operation were lower in both groups than before induction of anesthesia (P<0.05), but the study group was significantly higher than the control group (P<0.05). The incidence of restlessness (1.64% vs 14.93%) and the incidence of complications (18.03% vs 35.82%) in the study group were significantly lower than those in the control group (P<0.05). Conclusion: Dexmedetomidine is used for general anesthesia in elderly patients with lower limb fractures, which can reduce restlessness during recovery, reduce postoperative complications, reduce stress response, and improve immune function.
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2021, Vol. 27 
