ArticleFrontiers in pharmacology2024
Effects of dexmedetomidine-ropivacaine assisted combined spinal-epidural anesthesia on neutrophil-lymphocyte ratio and postoperative delirium in elderly patients with intertrochanteric femoral fracture.
Article in Frontiers in pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Rehabilitation-Cognition Integrated Care Program for Elderly With Lower Limb Fractures and Cognitive Impairment: Development and Efficacy.Brain and behavior · 2026Trial
- Dexmedetomidine as an Adjuvant in Femoral Nerve Block for Ease of Preoperative Positioning and Postoperative Analgesia in Hip and Proximal Femur Surgery.Anesthesiology and pain medicine · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Intertrochanteric femoral fracture (IFF) is a public issue in the old. Combined spinal-epidural anesthesia (CSEA) is commonly utilized for lower limb orthopedic surgery in elderly patients. Therefore, this study explored the application of dexmedetomidine (Dex) and ropivacaine (Rop) assisted CSEA in elderly IFF patients. Methods: Totally 187 elderly IFF patients were assigned into the Rop assisted CSEA (Rop-CSEA), low-dose Dex-Rop assisted CSEA (low Dex and Rop-CSEA) and high-dose Dex-Rop assisted CSEA (high Dex and Rop-CSEA) groups. We compared block effects, hemodynamic indicators [heart rate (HR)/respiratory rate (RR)/mean arterial pressure (MAP)] at time before anesthesia (T0)/skin incision (T1)/10 min postoperatively (T2)/suture postoperatively (T3)/anesthesia recovery (T4), postoperative pain mediator release [substance P (SP)/prostaglandin E2 (PGE2)/5-hydroxytryptamine (5-HT)], neutrophil-lymphocyte ratio (NLR), adverse reactions, delirium and cognitive dysfunction incidence. Results: Compared with the Rop-CSEA group, low/high Dex and Rop-CSEA groups had shortened onset times, prolonged recovery times in sensory/motor block, elevated HR/RR/MAP, repressed pain mediator release, and reduced postoperative delirium and cognitive dysfunction incidences. HR/RR/MAP exhibited reductions followed by elevations at T2-T4, and SP/PGE2/5-HT levels revealed elevations in all groups postoperatively. NLR level displayed enhancement followed by reduction, and NLR in the low/high Dex and Rop-CSEA groups was abated on postoperative days 1-5. Total incidence of adverse reactions in the high Dex and Rop-CSEA group was enhanced. Conclusion: Dex and Rop assisted CSEA shortens the onset time of anesthesia, maintains perioperative hemodynamic stability, inhibits pain mediator release, reduces postoperative NLR level and the incidence of delirium and cognitive dysfunction in IFF patients.
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