右美托咪定超前镇静对腹腔镜胆囊切除术老年患者应激反应的影响  

The Effect of Dexmedetomidine Ahead of Sedation for Stress Response of Laparoscopic Cholecystectomy in Elderly Patients

作　　者：甘国胜[1] 阮剑辉[1] 秦明哲[1] 李师宏[1] 胡光俊[1] 宋晓阳[1] 

机构地区：[1]广州军区武汉总医院麻醉科,武汉430070

出　　处：《中国医药导刊》2014年第5期834-835,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨右美托咪定超前镇静对老年患者行腹腔镜胆囊切除术应激反应的影响。方法:选取我院80例行腹腔镜胆囊切除术的老年患者,随机均分为对照组(麻醉开始前15min静脉泵注生理盐水)和观察组(麻醉开始前15min静脉泵注右美托咪定0.6ug/kg),记录T1、T2、T3、T4、T5、T6的血流动力学变化,拔管时间,各时点血糖、肾上腺素、IL-6、CRP和血清皮质醇水平。结果:对照组在T2、T3、T4、T5时间点的血压和心率波动较大,观察组血压和心率平稳,两组比较差异有统计学意义(P<0.05)。SpO2和拔管时间无显著差异(P>0.05),对照组在T2、T3、T5、T6时间点的血糖、肾上腺素、IL-6、CRP和血清皮质醇水平波动较大,与观察组比较有显著差异(P<0.05)。结论:右美托咪定超前镇静,能够维持腹腔镜胆囊切除术老年患者术中的血流动力学稳定,有效抑制机体的应激反应,值得临床广泛推广使用。Objective：To study the effect of dexmedetomidine ahead of sedation for stress response of laparoscopic cholecystectomy in elderly patients.Methods：80 cases of laparoscopic cholecystectomy elderly patients were randomly divided into control and observation group.The control group were given intravenous infusion of normal saline before 15min of anesthesia.The observation group were given dexmedetomidine infusion set0.6ug/kg.Recording hemodynamic changes,extubation time,blood glucose, epinephrine,IL-6,CRP and serum cortisol levels at each time point of two groups.Results：The blood pressure and heart rate of control group fluctuations inT2,T3,T4,T5point,while observation group is steady（P〈0.05）.SpO2 had no significant differences（P〉0.05）.The glucose,epinephrine,IL-6,CRP and serum cortisol level of control group fluctuations inT2,T3,T5,T6point,compared with observation group had significant differences（P〈0.05）.Conclusion：Dexmedetomidine ahead of sedationmaintain maintains hemodynamic stability in laparoscopic cholecystectomy in elderly patients.It＇s effectively to inhibit the body＇s stress response.

关 键 词：右美托咪定 超前镇静 腹腔镜胆囊切除 应激反应 

分 类 号：R614[医药卫生—麻醉学]