SEDline镇静监测下右美托咪定在胸腔镜肺叶切除术病人中的应用  

Application value of the dexmedetomidine under SEDline sedation monitoring in patients treated with thoracoscopic lobectomy

作　　者：凌云志[1] 禹莉 李晓红[1] 梁启胜[1] 孙宜云 杨栋栋 LING Yun-zhi;YU Li;LI Xiao-hong;LIANG Qi-sheng;SUN Yi-yun;YANG Dong-dong(Department of Anesthesiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;School of Laboratory Medicine,Bengbu Medical College,Bengbu Anhui 233030,China)

机构地区：[1]蚌埠医学院第一附属医院麻醉科,安徽蚌埠233004 [2]蚌埠医学院检验医学院,安徽蚌埠233030

出　　处：《蚌埠医学院学报》2021年第2期162-165,共4页Journal of Bengbu Medical College

基　　金：安徽省高等学校自然科学研究重点项目(KJ2019A0330)。

摘　　要：目的:通过SEDline镇静监测下右美托咪定在胸腔镜肺叶切除术病人中的应用,以期为麻醉选择更为安全有效的方法。方法:选择ASAⅠ或Ⅱ级的胸腔镜肺叶切除术病人20例,采用随机数字表法分为右美托咪定组(D组)和对照组(N组),每组10例。记录2组病人麻醉诱导前(T_(0))、切皮时(T_(1))、单肺通气30 min(T_(2))、术毕即刻(T_(3))的平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO 2)、病人状态指数(PSI);记录2组病人术中瑞芬太尼和丙泊酚的用量;以及术后6 h、24 h VAS评分和Ramsay评分。结果:2组病人在T_(1)、T_(2)、T_(3)时间点MAP均降低(P<0.01),HR减慢(P<0.01),PSI均降低(P<0.01)。其中,N组在T_(2)时间点MAP降低较D组更明显(P<0.01),D组在T_(1)时间点HR低于N组(P<0.01),在T_(2)时间点PSI低于N组(P<0.01);术中瑞芬太尼和丙泊酚的用量D组均明显低于N组;在术后6 h VAS评分D组低于N组(P<0.01),术后6 h Ramsay评分D组高于N组(P<0.01)。结论:胸腔镜肺叶切除术病人行右美托咪定联合SEDline镇静监测,术中病人麻醉状态得以控制,血流动力学更加平稳,术后镇静镇痛更加完善,无术后躁动,能对病人的快速康复起到一定的积极作用。Objective:To evaluate the application value of dexmedetomidine under SEDline sedation monitoring in thoracoscopic lobectomy in order to provide a more safe and effective method for anesthesia.Methods:A total of 20 ASAⅠorⅡpatients treated with thoracoscopic lobectomy were randomly divided into the dexmedetomidine group(group D)and control group(group N)(10 cases in each group).The MAP,HR,SpO 2 and PSI in two groups before anesthesia induction(T_(0)),during skin incision(T_(1)),after 30 minutes of one lung ventilation(T_(2))and immediately after surgery(T_(3))were recorded.The dosage of remifentanil and propofol,and scores of VAS and Ramsay after 6 h and 24 h of operation were recorded.Results:The MAP,HR and PSI in two groups at T_(1),T_(2) and T_(3) decreased(P<0.01),the decreasing degree of MAP in group N was more obvious compared with the group D at T_(2)(P<0.01),the HR in group D at T_(1)was significantly lower than that in group N(P<0.01),and the PSI in group D was lower than that in group N at T_(2)(P<0.01).The dosage of remifentanil and propofol in group D were significantly lower than these in group N.The scores of VAS and Ramsay in group D were lower and higher than that in group N after 6 h of operation,respectively(P<0.01).Conclusions:The dexmedetomidine under SEDline sedation monitoring in patients treated with thoracoscopic lobectomy can control the patient′s anesthetic state,maintain the hemodynamics,improve the postoperative sedation and analgesia,and have no postoperative agitation,which can plays certain positive roles in the patient′s quick recovery.

关 键 词：SEDline镇静监测 右美托咪定 胸腔镜 肺叶切除术 

分 类 号：R614.24[医药卫生—麻醉学]