右美托咪定用于胸椎旁神经阻滞对开胸手术患者氧化应激及炎性反应的影响分析  

Analysis of the Effect of Dexmedetomidine on Thoracic Paravertebral Nerve Block on Oxidative Stress and Inflammatory Response in Patients Undergoing Thoracotomy

作　　者：陈华永[1] 马丹丹 张华朋[1] 李鹏 赵晓东[1] CHEN Huayong;MA Dandan;ZHANG Huapeng;LI Peng;ZHAO Xiaodong(Department of Anesthesiology,Yidu Central Hospital,Weifang,Shandong Province,262500 China)

机构地区：[1]潍坊市益都中心医院麻醉科,山东潍坊262500

出　　处：《中外医疗》2021年第29期35-37,41,共4页China & Foreign Medical Treatment

基　　金：潍坊市2020年科技发展计划(医学类)(2020YX130)。

摘　　要：目的分析在开胸手术实施胸椎旁神经阻滞麻醉中应用右美托咪定对炎性反应和氧化应激反应的影响。方法研究对象为方便选择在2020年8—12月时间段在该院实施开胸手术的患者129例,以麻醉方式不同为依据实施分组,分为3组,采用罗哌卡因+右美托咪定麻醉、罗哌卡因麻醉、全麻的患者分别纳入1组、2组、3组,对3种麻醉方式实施不同时段炎性反应、氧化应激反应、麻醉安全性、不良反应。结果相比于T0时,在T2和T3时,3组患者的丙二醛均提升明显,差异有统计学意义(P<0.05);IL-6、TNF-α、C反应蛋白、皮质醇均提升显著,差异有统计学意义(P<0.05);而在T2和T3,相对比于2组和3组,1组IL-6、TNF-α、C反应蛋白、皮质醇、丙二醛均降低明显,差异有统计学意义(P<0.05);1组、2组、3组开胸手术患者并发症发生率分别为2.32%、13.95%、16.27%,差异有统计学意义(P<0.05)。结论在开胸手术实施胸椎旁神经阻滞麻醉中应用右美托咪定可将炎性反应和氧化应激反应有效减轻,麻醉安全性较高,建议推广。Objective To analyze the effect of dexmedetomidine on inflammatory response and oxidative stress during thoracic paravertebral nerve block anesthesia during thoracic surgery.Methods Selected conveniently 129 patients undergoing thoracotomy in the hospital during the period of August to December 2020 as the study object,grouped according to different anesthesia methods,divided into 3 groups,patients receiving ropivacaine+dexmedetomidine anesthesia,ropivacaine anesthesia,and general anesthesia were included in group 1,group 2,and group 3 respectively.The inflammatory response,oxidative stress response and the safety,adverse effects of anesthesia were implemented at different periods of time for the three anesthesia methods.Results Compared with T0,at T2 and T3,the malondialdehyde of the three groups increased significantly,and the difference was statistically significant(P<0.05);IL-6,TNF-α,C-reactive protein,cortisol all increased significantly,the difference was statistically significant(P<0.05);while at T2 and T3,compared with groups 2 and 3,group 1 IL-6,TNF-α,C-reactive protein,cortisol,and malondialdehyde all decreased significantly,the difference was statistically significant(P<0.05);the complication rates of patients undergoing thoracotomy in group 1,group 2,and group 3 were 2.32%,16.27%,and 13.95%,respectively,and the difference was statistically significant(P<0.05).Conclusion The application of dexmedetomidine in thoracic paravertebral nerve block anesthesia during thoracic surgery can effectively reduce the inflammatory response and oxidative stress response,and the anesthesia is safer.It is recommended to promote it.

关 键 词：开胸手术 胸椎旁神经阻滞麻醉 右美托咪定 炎性反应 氧化应激反应 

分 类 号：R614[医药卫生—麻醉学]