老年高血压病患者全麻苏醒期中右美托咪定的应用  

The application of dexmedetomidine of hemodynamic in elderly hypertensive patients during recovery period of general anesthesia

作　　者：颜华[1] 王梦娅 杨朋朋[1] 

机构地区：[1]泰山医学院附属医院,山东泰安271000 [2]肥城市人民医院,山东肥城271600

出　　处：《泰山医学院学报》2017年第5期521-523,共3页Journal of Taishan Medical College

摘　　要：目的探析右美托咪定对高血压老年患者全麻苏醒期血流动力学和躁动发生率的影响。方法选择2012年2月至2014年12月在我院接受胃癌根治术治疗的36例高血压老年患者的临床资料。随机将患者分成两组,即观察组(右美托咪定组)和对照组(生理盐水组)两组,每组18例。比较两组患者的一般资料、麻醉时间、手术时间、拔管时间以及停药至清醒的时间、不良反应发生率、躁动发生率、术后1 h的VAS评分、各时点HR和MAP值等。结果两组患者的一般资料、麻醉时间、手术时间、拔管时间以及停药至清醒的时间、不良反应发生率比较均无统计学差异(P>0.05)。观察组患者术后发生躁动的几率明显比对照组低,且躁动程度明显轻于对照组,均存在统计学差异(P<0.01);术后1 h的VAS评分,观察组患者明显比对照组低,差异有统计学意义(P<0.01)。观察组患者在围拔管期各时点的HR和MAP值均明显比对照组相应时点的值低,差异有统计学意义(P<0.05)。结论右美托咪定可以显著减少全麻高血压老年患者苏醒期时躁动的发生以及血流动力学的改变。Objective： To study the effect of dexmedetomidine on hemodynamies and agitation rate in elderly hypertensive patients during recovery period of general anesthesia. Methods： From February 2012 to December 2014, 36 cases of elderly patients with hypertension in our hospital were treated with radical gastrectomy for gastric cancer. Patients were randomly divided into two groups, the observation group （dexmedetomidine group） and control group （saline group）, with 18 cases in each group. The incidences were compared between the two groups in general, anesthesia time, operation time, extubation time and awake period, adverse reaction rate, incidence of agitation, postoperative l h VAS score, at each time point in HR and map values. Results：There were no significant differences in general information, anesthesia time, operation time, extubation time, and the time between the two groups, and the incidence of adverse reactions between the groups. Restless proba- bility in the patients of the observations group occurred more significantly than those in the control group, and restlessness was significantly lighter than that of the control group, there were statistical difference（ P 〈 0. 01 ） ;lh postoperative VAS scores in the observation group were obviously lower than those of the control group, and there was statistical difference （P 〈 0.01 ）. The HR and MAP values of the observation group were significantly lower than those in the control group at different time points, and there was statistical difference（ P 〈 0.05 ）. Conclusion： Dexmedetomidine can significantly reduce the recovery pe- riod of general anesthesia, agitation and hemodynamic changes in elderly hypertensive patients.

关 键 词：右美托咪定 高血压 全麻苏醒期 躁动 血流动力学 

分 类 号：R614.2[医药卫生—麻醉学]