七氟醚麻醉下右美托咪定复合罗哌卡因行肝脏部分切除术的临床效果及对预后影响  

Clinical effect of dexmedetomidine combined with ropivacaine in partial hepatectomy under sevoflurane anesthesia and its influence on prognosis

作　　者：田玲玲 Tian Lingling(Shanxian Central Hospital,Heze,Shandong 274300,China)

机构地区：[1]山东省单县中心医院,山东菏泽274300

出　　处：《首都食品与医药》2023年第1期68-70,共3页Capital Food Medicine

摘　　要：目的探讨七氟醚麻醉下右美托咪定复合罗哌卡因行肝脏部分切除术(PHX)的临床麻醉效果.方法选取单县中心医院2020年6月-2022年6月行PHX手术治疗的患者为研究对象,共有89例.按照麻醉方案的差异分组,其中对照组(n=45)以丙泊酚、瑞芬太尼常规麻醉,观察组(n=44)在七氟醚麻醉下右美托咪定复合罗哌卡因麻醉.对比两组麻醉阻滞起效时间、拔管苏醒时间、恢复自主呼吸时间,麻醉不同阶段平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS)变化,评价麻醉不同时间苏醒室标准(Aldrete)、改良警觉-镇静量表(OAA/S)评分,最后统计两组不良反应发生情况.结果观察组麻醉阻滞起效时间短于对照组,恢复自主呼吸时间短于对照组(P<0.05).两组患者在麻醉诱导前(T0)MAP、HR、BIS对比差异不显著(P>0.05);观察组插管即刻(T1)至拔管后即刻(T2)至术毕(T3)阶段其MAP、HR、BIS波动更小,组内对比差异更小.观察组拔管即刻、拔管15min时Aldrete评分高于对照组,OAA/S高于对照组(P<0.05).两组麻醉相关不良反应发生率对比,差异不显著(P>0.05).结论右美托咪定复合罗哌卡因可加快麻醉阻滞生效时间,使患者在术中达到预期麻醉深度,极大控制血压等生理指标的波动,有助于手术的顺利实施;其次该麻醉方案在术后镇静表现中也较为理想,可缓解术后疼痛的发生,同时安全性较高.Objective To investigate the clinical anesthetic effect of dexmedetomidine combined with ropivacaine under sevoflurane anesthesia for partial hepatectomy(PHX).Methods Eighty-nine patients who underwent PHX surgery in our hospital from June 2020 to June 2022 were selected as the research objects.The control group(n=45)was anesthesia with propofol and remifentanil,while the observation group(n=44)was anesthesia with dexmedetomidine combined with ropivacaine under sevoflurane anesthesia.The onset time of anesthesia block,recovery time of extubation,recovery time of spontaneous breathing,changes of mean arterial pressure(MAP),heart rate(HR),bispectral index(BIS)in different stages of anesthesia were compared between the two groups,and the Aldrete and modified Alert-Sedation Scale(OAA/S)scores were evaluated.Finally,the incidence of adverse reactions in the two groups was counted.Results The onset time of anesthesia block in the observation group was shorter than that in the control group,and the recovery time of spontaneous breathing was shorter than that in the control group(P<0.05).There were no significant differences in MAP,HR and BIS between the two groups before induction of anesthesia(TO)(P>0.05).In the observation group,the fluctuation of MAP,HR and BIS was smaller from immediately after intubation(T1)to immediately after extubation(T2)to the end of operation(T3),and the intra-group comparison difference was smaller.Aldrete score and OAA/S in the observation group were higher than those in the control group at the moment of extubation and 15min after extubation(P<0.05).There was no significant difference in the incidence of anaesthesia related adverse reactions between the two groups(P>0.05).Conclusions Dexmedetomidine combined with ropivacaine can accelerate the effective time of anesthesia block,make patients reach the expected depth of anesthesia during the operation,greatly control the fluctuation of blood pressure and other physiological indicators,which is helpful to the smooth implementation of surgery

关 键 词：七氟醚 右美托咪定 罗哌卡因 麻醉方案 肝脏切除 

分 类 号：R971.2[医药卫生—药品]