右美托咪定全身麻醉联合硬膜外麻醉对老年腹腔镜胆囊切除术患者Ramsay评分、MAP和HR的影响  

Effect of dexmedetomidine combined with epidural anesthesia on Ramsay sedation score,mean arterial pressure and heart rate in elderly patients receiving laparoscopic cholecystectomy

作　　者：王小静 胡清波 任冰冰 Wang Xiaojing;Hu Qingbo;Ren Bingbing(Anesthesiology Department,Luanchuan People's Hospital,Luoyang Henan 471000,China)

机构地区：[1]栾川县人民医院麻醉科,河南洛阳471000

出　　处：《保健医学研究与实践》2022年第9期32-35,共4页Health Medicine Research and Practice

摘　　要：目的探讨右美托咪定全身麻醉联合硬膜外麻醉对老年腹腔镜胆囊切除术患者Ramsay评分、平均脉动压(MAP)和心率(HR)的影响,以期为临床治疗提供参考。方法选择2019年2月—2021年7月于栾川县人民医院行腹腔镜胆囊切除术的126例老年患者作为研究对象,采用随机数字表法将患者分为研究组与对照组,每组63例。研究组患者采用右美托咪定全身麻醉联合硬膜外麻醉,对照组患者采用硬膜外麻醉。比较2组患者给药前(T0)、给药后5 min(T1)、给药后10 min(T2)、术中牵拉胆囊时(T3)、手术结束时(T4)5个时间点的镇静Ramsay评分、MAP和HR。比较2组患者术后8 h、16 h、20 h、24 h视觉模拟评估量表(VAS)评分。比较2组患者术后不良反应发生情况。结果2组患者T0时Ramsay评分、MAP和HR比较,差异无统计学意义(P>0.05)。2组患者T1、T2、T3、T4时Ramsay评分高于T0,差异有统计学意义(P<0.05)。2组患者T1、T2、T3、T4时MAP和HR低于T0,差异有统计学意义(P<0.05)。2组患者T1、T2、T3、T4时Ramsay评分、MAP和HR差异均具有统计学意义(P<0.05)。研究组患者术后8 h、16 h、20 h的VAS评分均低于对照组,差异具有统计学意义(P<0.05)。2组患者术后24 h的VAS评分比较,差异无统计学意义(P>0.05)。2组患者均未发生不良反应。结论右美托咪定全身麻醉联合硬膜外麻醉在老年腹腔镜胆囊切除术中具有满意麻醉效果,在稳定术中血流动力学指标以及降低术后疼痛方面效果明显,值得临床推广应用。Objective To investigate the effect of dexmedetomidine combined with epidural anesthesia on Ramsay sedation score,mean arterial pressure(MAP)and heart rate(HR)in elderly patients underwent laparoscopic cholecystectomy to provide reference for clinical treatment.Methods A total of 126 elderly patients who underwent laparoscopic cholecystecto-my in Luanchuan People's Hospital from February 2019 to July 2021 were selected as the study subjects.The patients were assigned to the experimental group and the control group by the random number table,with 63 cases in each group.Patients in the experimental group received general anesthesia with dexmedetomidine combined with epidural anesthesia,and patients in the control group were treated with epidural anesthesia.The Ramsay sedation score,MAP,and HR were compared be-tween the 2 groups at five time points:before administration(T0),5 min after administration(T1),10 min after adminis-tration(T2),during intraoperative gallbladder traction(T3),and at the end of surgery(T4).Visual analogue scale(VAS)scores were compared between the 2 groups at 8 h,16 h,20 h,and 24 h after surgery.Postoperative adverse reactions were compared between the two groups.Results There was no significant difference in Ramsay sedation score,MAP,and HR at T0 between the two groups(P>0.05).Ramsay scores at T1,T2,T3,and T4 were significantly higher than T0 in the 2 groups(P<0.05).MAP and HR at T1,T2,T3,and T4 were significantly lower than T0 in the 2 groups(P<0.05).There were significant differences in Ramsay sedation score,MAP,and HR at T1,T2,T3,and T4 between the 2 groups(P<0.05).The VAS scores at 8 h,16 h,and 20 h after operation in the experimental group were significantly lower than those in the control group(P<0.05).There was no significant difference in VAS score at 24 h after operation between the two groups(P>0.05).No adverse reactions were observed in the 2 groups.Conclusion Dexmedetomidine in combination with epidural anesthesia has a satisfactory anesthetic effect in elderly patients who underw

关 键 词：右美托咪定 老年 腹腔镜胆囊切除术 镇痛 

分 类 号：R614.2[医药卫生—麻醉学]