Abstract:

Objective

To observe the effect of different doses of dexmedetomidine nasal drops in the elderly percutaneous vertebroplasty （PVP）.

Methods

A total of 100 elderly patients who underwent elective Percutaneous Vertebroplasty （PVP） at the Traditional Chinese Medicine Hospital of Pi District，Chengdu City from June to December 2023， including 38 males and 62 females. Their ages ranged from 60 to 79 years old， with an average age of （69.08±4.86） years. Patients were divided into 4 groups（n=25） by random number table method： dexmedetomidine 0.8 μg/kg group （D1 group）， 1.0 μg/kg group （D2 group）， 1.2 μg/kg group （D3 group） and normal saline control group （N group）. Ramsay calm score， visual analog scale （VAS）， mean arterial pressure （MAP）， heart rate （HR） and pulse oxygen saturation （SpO₂） were compared immediately after entering the operating room （T1）， 30 min after nasal drops （T2）， immediately after cannula reached vertebra （T3）， bone cement injection （T4）， and 5 min after resuming position （T5）between the groups. Intraoperative adverse reactions were recorded.

Results

The sedation score at each time point of D3 group after nasal drip was higher than that of other groups （P＜0.05）.At T3 and T4，the pain score of D3 group was lower than that of other groups （P＜0.05）. There was no significant difference in MAP and HR of D3 group at T3 and T4 compared with T2 （P＞0.05）.Postoperative blood glucose in all groups was higher than that before surgery （P＜0.05）， and the increase of blood glucose in D3 group was lower than that in other groups （P＜0.05）. The amount of lidocaine and operation time in D3 group were lower than those in other groups （P＜0.05）， and the satisfaction score in D3 group was higher than that in other groups （P＜0.05）.The incidence of agitation and intraoperative hypertension in group N was higher than that in other groups（P＜0.05）.However，there was no statistical difference in the occurrence of adverse reactions among all groups（P＞0.05）.

Conclusion

For elderly patients undergoing PVP treatment， 1.2 μg/kg of dexmedetomidine can be effectively sedated and analgesic before operation，and patients are safer，more comfortable and satisfied.

Key words: Dexmedetomidine, Nose drip, Aged, Percutaneous vertebroplasty