右美托咪定联合丙泊酚对老年脑动脉瘤介入栓塞术患者的麻醉效果及对呼吸、血流动力学的影响  

Effect of Dexmedetomidine Combined with Propofol on Anesthesia,Respiratory and Hemodynamics in Elderly Patients with Cerebral Aneurysm Undergoing Transcatheter Arterial Embolization

作　　者：刘洋[1] 梁启胜[1] 王南海[1] LIU Yang;LIANG Qisheng;WANG Nanhai(Department of Anesthesia,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院麻醉科,安徽蚌埠233000

出　　处：《医学综述》2020年第9期1851-1855,共5页Medical Recapitulate

摘　　要：目的研究右美托咪定联合丙泊酚在老年脑动脉瘤介入栓塞手术中的麻醉效果及对呼吸、血流动力学的影响。方法选取2017年3月至2019年3月蚌埠医学院第一附属医院收治的83例老年脑动脉瘤患者为研究对象,根据麻醉方法不同分为观察组(n=41)和对照组(n=42),两组患者均采取介入栓塞术治疗,观察组术中给予右美托咪定联合丙泊酚麻醉用药,对照组给予右美托咪定联合瑞芬太尼麻醉用药。监测两组麻醉前、麻醉诱导后、手术切皮时、手术结束苏醒后血流动力学指标及自主呼吸频率(RR)的变化。观察两组患者术后苏醒时间、清醒时间及治疗期间不良反应发生情况。结果麻醉诱导后、手术切皮时观察组血流动力学各指标及RR均低于麻醉前及对照组(P <0. 05);手术结束苏醒后观察组血流动力学各指标及RR与本组麻醉前及对照组比较差异无统计学意义(P>0. 05)。观察组苏醒时间及清醒时间均短于对照组[(6. 83±1. 42) min比(8. 57±2. 16) min,(17. 25±2. 31) min比(18. 58±3. 12) min](P <0. 05)。观察组总不良反应发生率低于对照组[17. 17%(7/41)比45. 24%(19/42)](P <0. 05)。结论右美托咪定联合丙泊酚麻醉用药在老年动脉栓塞术患者中具有良好镇痛效果,且能明显减轻恶心、呕吐、低血压等不良反应,对患者血流动力学各指标及RR的影响较明显,但不会出现各指标持续降低或升高的情况。Objective To investigate the effect of dexmedetomidine combined with propofol on anesthesia,respiratory and hemodynamics in elderly patients with cerebral aneurysm undergoing transcatheter arterial embolization. Methods The elderly patients with cerebral aneurysms admitted to the First Affiliated Hospital of Bengbu Medical College from Mar. 2017 to Mar. 2019 were enrolled,and according to the method of anesthesia divided into an observation group( n = 41) and a control group( n = 42). Both groups underwent transcatheter arterial embolization. The observation group was given dexmedetomidine combined with propofol for anesthesia,while the control group was given dexmedetomidine combined with remifentanil. Heart rate,pulse oxygen saturation,systolic blood pressure,diastolic blood pressure and spontaneous respiratory rate( RR) of the two groups were monitored before anesthesia,after anesthesia induction,at the beginning of surgery,and end of the surgery after awakening. The postoperative recovery time,awakening time and adverse reactions during the treatment were observed. Results The hemodynamic parameters and RR of the observation group after anesthesia induction and at the beginning of surgery were lower than those before surgery and those in the control group( P < 0. 05). The hemodynamic parameters and RR of the observation group at end of the surgery had no difference with those before anesthesia and those in the control group( P < 0. 05). The awakening time of the observation group was shorter than that of the control group[( 6. 83 ± 1. 42) min vs( 8. 57 ± 2. 16) min,( 17. 25 ± 2. 31) min vs( 18. 58 ± 3. 12) min]( P < 0. 05). The total incidence rate of adverse reactions in the observation group was lower than that in the control group[17. 17%( 7/41) vs45. 24%( 19/42) ]( P < 0. 05). Conclusion Dexmedetomidine combined with propofol has a good analgesic effect in the elderly patients with arterial embolization,and can significantly reduce adverse reactions such as nausea,vomiting,and hypotension. It has a si

关 键 词：老年脑动脉瘤 右美托咪定 丙泊酚 麻醉效果 血流动力学 

分 类 号：R739.41[医药卫生—肿瘤] R322.81[医药卫生—临床医学]