眼科手术患者给予右美托咪定持续泵注与诱导前负荷剂量静推的麻醉效果  

Anesthetic Effect of Continuous Infusion of Dexmedetomidine and Intravenous Injection of Induction Preload Dose in Patients undergoing Ophthalmic Surgery

作　　者：张可汗 程娜 ZHANG Ke-Han;CHENG Na(Eye center of the Second Affiliated Hospital of Medical College of Zhejiang University(Eye Hospital of Zhejiang University),Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属第二医院眼科中心(浙江大学眼科医院),杭州310000

出　　处：《中国药物经济学》2022年第11期79-82,86,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨右美托咪定持续泵注与诱导前负荷剂量静推对眼科手术患者应激指标及并发症发生情况的影响。方法选取2021年7月至2022年2月于浙江大学医学院附属第二医院接受眼科手术的102例患者作为研究对象,依据随机数字表法分为对照组与观察组,前者麻醉诱导前负荷剂量0.9%氯化钠注射液静注联合术中维持泵注,后者麻醉诱导前负荷剂量右美托咪定静注联合术中持续泵注。比较两组患者血流动力学[心率(HR)、舒张压(DBP)及收缩压(SBP)]、镇痛效果[视觉模拟评分法(VAS)评分]、应激指标[肾上腺素(E)、皮质醇(Cor)及去甲肾上腺素(NE)]、免疫指标(CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))及不良反应发生率。结果手术开始时(T1)、手术30 min(T2)及拔管时(T3)观察组患者HR、DBP及SBP水平均低于对照组(P<0.05)。术后6 h、12 h及24 h观察组患者VAS评分均低于对照组(P<0.05)。术后24 h,观察组患者CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)水平均高于对照组(P<0.05)。术后24 h观察组患者E、Cor及NE水平低于对照组(P<0.05)。观察组患者不良反应发生率略高于对照组,但比较差异无统计学意义(P>0.05)。结论右美托咪定持续泵注与诱导前负荷剂量静推有利于维持眼科手术患者围术期血流动力学稳定,减少术后疼痛、免疫功能抑制及应激反应发生。Objective To explore the effects of dexmedetomidine continuous pumping and induced preload dose pushing on stress indexes and complications in patients undergoing ophthalmic surgery.Methods Selected in July 2021 to February 2022 eye surgery patients treated in the Second Affiliated Hospital of Medical College of Zhejiang University as the research object,the 102patients on the basis of stochastic indicator method is divided into control group and observation group,the former load before anesthesia induction dose of physiological saline combined intraoperative maintain pump injection intravenous administration of the loading dose right before anesthesia induction beauty holds the mi static combined intraoperative continuous pump injection.Hemodynamics[heart rate(HR),diastolic blood pressure(DBP)and systolic blood pressure(SBP)],analgesic effect[visual analogue pain(VAS)score],stress indexes[adrenaline(E),cortisol(Cor)and norepinephrine(NE)],immune indexes(CD4^(+),CD8^(+)and CD4^(+)/CD8^(+))and adverse effects were compared between 2 groups Reaction rate.Results The levels of HR,DBP and SBP in observation group were lower than those in control group at the beginning of surgery(T1),30min of surgery(T2)and extubation(T3)(P<0.05).VAS score of observation group was lower than control group 6 h,12 h and 24 h after surgery(P<0.05).24 h after operation,the levels of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in observation group were higher than those in control group(P<0.05).24 h after operation,the levels of E,Cor and NE in observation group were lower than those in control group(P<0.05).The incidence of adverse reactions in observation group was slightly higher than that in control group,but there was no statistical significance(P>0.05).Conclusion Continuous pumping of dexmedetomidine and induced preload dose pushing can maintain perioperative hemodynamic stability in patients undergoing ophthalmic surgery,and reduce postoperative pain,immune suppression and stress response,which is worthy of promotion.

关 键 词：右美托咪定 眼科手术 应激反应 血流动力学 免疫指标 

分 类 号：R779.6[医药卫生—眼科] R971[医药卫生—临床医学]