Analgesic effect of epidural injection of hydromorphone combined with dexmedetomidine in elderly patients after total hip replacement

  Objective  To observe the analgesic effect of epidural injection of hydromorphone combined with dexmedetomidine in elderly patients after total hip arthroplasty.

  Methods  Seventy-eight patients undergoing total hip arthroplasty were randomly divided into study group and control group, with 39 cases in each group. The control group was given epidural injection of 0.3 mg hydromorphone after the operation, and the study group was sequentially injected with dexmedetomidine 0.5 μg/kg and hydromorphone 0.3 mg. Intravenous controlled analgesia by sufentanil was used in both groups. At 1, 4, 12, 24 h (T₁, T₂, T₃, T₄) after operation, Visual Analogue Scale(VAS) scores, Ramsay sedation score, heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO₂) of the two groups were compared. The sufentanil consumption dosage and adverse reactions were recorded.

  Results  The VAS scores and Ramsay scores at T₃ and T₄ of the study group were significantly lower than those of the control group at rest and exercise (P < 0.05). The Ramsay score at T₄ of the study group was significantly lower than that of T₁ (P < 0.05). HR at T₂ to T₄ and MAP at T₁ to T₃ in the study group were significantly lower than those in the control group (P < 0.05). Compared with T₁, the study group had decreased HR at T₂ to T₄, and the control group had decreased MAP at T₂ to T₄ (P < 0.05). The consumption of sufentanil in the study group was significantly less than that in the control group (P < 0.05). There was no difference in adverse reactions between the two groups (P>0.05).

  Conclusion  The epidural injection of hydromorphone combined with dexmedetomidine has a significant analgesic effect after total hip arthroplasty in the elderly, and has the functions of stabilizing hemodynamics and benefiting postoperative recovery.