Application of dexmedetomidine-assisted intravertebral anesthesia in hip replacement and its influence on T-lymphocyte subsets

Abstract

Application of dexmedetomidine-assisted intravertebral anesthesia for elderly patients with hip replacement and its influences on T-lymphocyte subsets in peripheral blood were assessed. Eighty-six patients undergoing intravertebral anesthesia in hip replacement were treated as group A, and one hundred patients undergoing intravertebral anesthesia combined with dexmedetomidine were treated as group B. Hemodynamic changes in both groups were compared 5 min before anesthesia (T0), immediately after skin incision (T1) and after surgery (T2). General operation conditions of patients in both groups were recorded. T-lymphocyte subsets, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), visual analogue scale (VAS) pain scores and mini-mental state examination (MMSE) cognitive function changes before surgery and 24 h after surgery were compared between the groups, and the incidence of complications in both groups after 24 h was recorded. The recovery time of patients in group B was shorter than that of group A (P<0.05). Changes of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate fluctuations in group B were lower than those in group A (P<0.05). At 24 h after surgery, VAS scores of group B were lower than those of group A (P<0.05); levels of IL-6 and TNF-α were lower than those of group A (P<0.05); CD3⁺ cells, CD4⁺ cells, CD8⁺ cells, and CD4/CD8 ratio were higher than those of group A (P<0.05), and MMSE score was higher than that of group A (P<0.05). The incidence of gastrointestinal reactions and postoperative cognitive dysfunction (POCD) in group B was lower than that in group A (P<0.05). In conclusion, administration of dexmedetomidine can effectively shorten the recovery time of patients, stabilize intraoperative hemodynamics of patients, protect immune function, and reduce postoperative pain and POCD occurrence during anesthesia of hip replacement.

Keywords: T-lymphocyte subsets; dexmedetomidine; hip replacement; intravertebral anesthesia.

Figure 1

Analysis of the general condition of surgery of patients in both groups. (A) Time of operation; (B) anesthesia time; (C) amount of bleeding; (D) infusion volume; (E) awakening time. ^*P<0.05.

Figure 2

Differences in postoperative VAS scores of patients between the groups. ^*P<0.05.

Figure 3

Analysis of changes in T-lymphocyte subsets of patients in both groups. (A) CD3⁺ cell levels in both groups; (B) CD4⁺ cell levels in both groups; (C) CD8⁺ cell levels in both groups; (D) CD4/CD8 ratio of patients between the groups. ^*P<0.05.

Figure 4

Differences in MMSE scores of patients between the groups after surgery. ^*P<0.05. MMSE, mini-mental state examination.