右美托咪定对老年胃癌根治术患者围术期血流动力学及术后镇静镇痛的影响  

Effects of Dexmedetomidine on perioperative hemodynamics and postoperative sedation and analgesia in elderly patients treated with radical gastric cancer surgery

作　　者：移小峰[1] 巫绍汝 彭艳[1] Yi Xiaofeng;Wu Shaoru;Peng Yan(Department of Anesthesiology,the First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院麻醉科,苏州215000

出　　处：《中华老年医学杂志》2021年第5期637-640,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨老年胃癌根治术全身麻醉患者术中应用右美托咪定进行辅助麻醉对患者围术期血流动力学、术后镇静镇痛效果的影响。方法2019年1月至2020年4月本院所收治的行胃癌根治术患者63例作为观察对象,均采用全身麻醉方式,按照入选序号奇偶性分别采用右美托咪定(奇数组)和等量生理盐水(偶数组)进行麻醉辅助,对两组患者围术期血流动力学指标变化情况、麻醉药物用量进行监测记录,并采用镇静评分系统(Ramsay)和视觉模拟评分系统(VAS)对其术后镇静、镇痛效果进行评估。结果右美托咪定组患者麻醉诱导前(T1)、插管后即刻(T3)、拔管后即刻(T5)平均动脉压和心率水平均低于生理盐水组(均P<0.05);右美托咪定组患者术后1 h、术后4 h Ramsay评分均高于生理盐水组,VAS评分均低于生理盐水组(均P<0.05);右美托咪定组患者术中丙泊酚(1121.5±198.5)mg、瑞芬太尼(3.1±0.9)mg用量均低于生理盐水组(1395.6±332.7)mg、(5.5±1.2)mg(均P<0.05)。结论对胃癌根治术行全身麻醉患者采用右美托咪定进行麻醉辅助,可有效保持患者术中血流动力学指标的稳定,并在降低麻醉药物用量的同时增强镇静、镇痛效果。Objective To investigate the effects of Dexmedetomidine for supplemental anesthesia on perioperative hemodynamics and postoperative sedation and analgesia in elderly patients receiving radical gastric cancer surgery under general anesthesia.Methods From January 2019 to April 2020,63 patients admitted to our hospital for radical gastric cancer surgery were included as observation objects.They all underwent general anesthesia and were divided into the Dexmedetomidine group(odd-numbered group)and the normal saline group(even-numbered group)according to the parity of serial numbers the subjects were assigned to.Changes in perioperative hemodynamic index values and the amounts of anesthetic drugs used in the two groups were monitored and recorded,and postoperative sedation and analgesia effects were evaluated by using the Ramsay sedation scale and the visual analog scale(VAS).Results The mean artery pressure(MAP)and heart rate(HR)were lower in the Dexmedetomidine group than in the normal saline group before anesthesia induction(T1),immediately after intubation(T3)and immediately after extubation(T5)(P<0.05).The Ramsay scores were higher and the VAS scores were lower in the Dexmedetomidine group than in the normal saline group at 1 h and 4 h after surgery(P<0.05).The doses of intraoperative propofol and remifentanil were lower in the Dexmedetomidine group than in the normal saline group[(1121.5±198.5)mg vs.(1395.6±332.7)mg,(3.1±0.9)mg vs.(5.5±1.2)mg,P<0.05].Conclusions The use of Dexmedetomidine for supplemental anesthesia can effectively maintain the stability of the patient's intraoperative hemodynamics and enhance the sedative and analgesic effects while reducing the amount of anesthetic drugs in patients receiving radical gastric cancer surgery under general anesthesia.

关 键 词：胃肿瘤 右美托咪啶 血流动力学 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]