Objective: To observe the clinical effect of lower limb warming blanket combined with dexmedetomidine (DEX) in preventing postoperative delirium (POD) and chills in elderly patients undergoing spinal surgery. Methods: A total of 160 elderly patients undergoing posterior spinal surgery under general anesthesia were selected and divided into control group (group N), heating group (group T), DEX group (group D) and heating combined with DEX group (group TD) according to the random number table method, 40 cases in each group. T group and TD group routine insulation and lower limb heating blanket. DEX was injected in group D and group TD. The dosage of anesthetics, the changes of body temperature and heart rate at different time points during operation, and the occurrence of postoperative chills and POD were compared among the groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
160
Dexmetomidine (H20183219) 0.4μg / (kg·min)；
Beijing Maikang Medical Device Co., Ltd., Model: Warm-1-1.
Jincheng General Hospital
Jincheng, Shanxi, China
Intraoperative vital signs monitoring
nasopharyngeal temperature
Time frame: 1 hour
Intraoperative vital signs monitoring
nasopharyngeal temperature
Time frame: 2 hour
Intraoperative vital signs monitoring
nasopharyngeal temperature
Time frame: 3 hour
The incidence of postoperative chills
chills refer to the Wrench classification criteria as follows : 0: no chills; grade 1: peripheral vascular contraction, vertical hair, but no muscle fibrillation; level 2: only one muscle group had muscle fibrillation; grade 3: muscle fibrillation in multiple groups; level 4: general tremor; ≥ 1 level was judged to have chills.
Time frame: 1 hour
The incidence of POD after operation
The results of POD in each group were recorded, and the POD was evaluated by CAM-CR scale. The incidence of POD at 24,48 and 72 h after operation was compared among the groups
Time frame: 1 day
Postoperative extubation time
The recovery time from the end of surgery to extubation was recorded.
Time frame: 1 hour
Postoperative incision infection rate
The incidence of postoperative incision infection was recorded.
Time frame: 1 hour
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