艾司氯胺酮复合右美托咪定对老年部骨折患者睡眠质量的影响

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TheEffect ofLow-doseEsketamine Combined with Dexmedetomidine on Sleep Quality in Elderly Patients with Hip Fractures

LIUFeifei

Departmentofnesthesilogy，jangCityHospital/anghaiSixthPeple'sHspitalFujnHspitalQuanzhou32ina）

AbstractObjective：To investigatetheanalgesicandsedativeefectsoflow-doseesketaminecombinedwithdexmedetomidine anesthesiainelderlypatients withipfracturesduringsurgeryaswellasits impactonslepquality.Methods：Atotalof1patientswithhipfracturesadmitedtoJinjiang Hospital（Shanghai SixthPeople'sHospitalFujianHospital）fromDecember2022to December2O24 wereselectedastheresearch subjects.Accordingtothedosageofesketamine，theywere divided intoalow-dose group（ n=50，0.1mg/kg esketamine +0.5μg/kg dexmedetomidine） and a conventional-dose group（ n=50，0.2mg/kg esketamine dexmedetomidine）.Anesthesia induction was performed.The Richmond Agitation-Sedation Scale（RASS） scores，Visual Analogue Scale（VAS）scores，andPitsburgh SleepQuality Index（PSQI）scoreswere evaluatedand compared.Results：There wasno significant diference inRASSand VASscores betweenthetwo groups before entering the postanesthesia care unit（ P>0.05） . The RASS and VAS scores gradually decreased at 3O minutes and 6O minutes after entering the post-anesthesia care unit，but there was no significant difference between the two groups（ P>0.05 ）.There was no significant difference in the preoperative PSQI scores between the two groups （ P>0.05 ）. The PSQI scores of the two groups on postoperative day 1 and 3 were lower than those before surgery（ P<0.05. ），with the low-dose group having lower PSQI scores than the conventional-dose group on postoperative day 3（P<0.05） .Conclusion：The combination of low-dose esketamine and dexmedetomidine anesthesiaregimen forhipfracture surgerycanimprovesleepqualitywhileensuringanalgesicandsedativeefects，whichis worthy of promotion.

KeywordsLow-dose；Esketamine；Dexmedetomidine;Elderly； Hip fracture； Sedation；Analgesia;Sleep qualit中图分类号：R274.1;R338.63 文献标识码：A doi：10.3969/j. issn. 2095 -7130.2025.07.012

髋部骨折是临床存在较高发生率的骨折类型，主要是因突然性交通意外等因素导致的病变，患者表现为骨折移位、髋部骨折持续疼痛等，可致使其生命质量迅速下降[1]。（剩余4922字）