Elderly patients undergoing posterior approach lumbar surgery
Conditions
Interventions
Dexmedetomidine (Group D):During induction, dexmedetomidine was administered intravenously at a dose of 0.5 µg/kg, and the maintenance dose was 0.2 µg/kg/h.
The esketamine group (Group E):Intravenously inject esketamine at a dose of 0.25mg/kg initially, and maintain the dosage at 0.125mg/kg/h.
The combined group of esketamine and dexmedetomidine (ED group):Induction with esketamine 0.25mg/kg + dexmedetomidine 0.5µg/kg, with maintenance doses of 0.125mg/kg/h and 0.2µg/kg/h, respectively.
Sponsors
Hefei First People's Hospital
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Patients who undergo elective posterior approach lumbar surgery (such as spinal canal decompression surgery, lumbar fusion surgery, etc.); 2. Age >= 60 years old, gender not limited, ASA classification I-III level; 3. No history of severe heart, lung, liver or kidney dysfunction or mental illness; 4. Clearly describe the content of the clinical trial, and patients voluntarily join and sign the informed consent form.
Exclusion criteria
Exclusion criteria: 1. The patient was already in a state of fatigue before the operation (with an ICFS-10 score greater than 24 points); 2. Allergic to esketamine or dexmedetomidine or having contraindications for their use; 3. Patients who have been using sedative/pain-relieving drugs for a long time; 4. Preoperative cognitive dysfunction (MMSE score < 24); 5. Patients who have taken pain-relieving and sedative medications recently; 6. Those with psychological or mental abnormalities or mental illnesses; 7. Severe heart (NYHA IV grade), liver (Child-Pugh C grade), and kidney (on dialysis) dysfunction; 8. Patients who participated in other treatments in the past 6 months (at the time of obtaining consent); 9. Patients who are judged to lack the ability to consent; 10. Other patients who were judged by the clinical responsible doctor or the clinical supervisor doctor to be unsuitable.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The incidence of postoperative fatigue; | — |
Secondary
| Measure | Time frame |
|---|---|
| The incidence of postoperative delirium;Anesthesia duration, operation time, recovery time, extubation time, intraoperative blood loss, intraoperative fluid infusion volume, urine output;QoR-15score;VAS pain grade;The time of the first postoperative ambulation and the length of hospital stay;Postoperative adverse reactions (such as nausea, vomiting, dizziness, double vision, nightmares, etc.);The RASS sedation score 30 minutes after the operation;Mean Arterial Pressure (MAP), Heart Rate, SpO2; | — |
Countries
China
Contacts
Public ContactYang Heng
Hefei First People's Hospital
Outcome results
None listed