心率变异性分析对老年患者术前鼻喷小剂量右美托咪啶的临床评价  

Clinical evaluation of preoperative nasal spray of low-dose dexmedetomidine in elderly patients by heart rate variability analysis

作　　者：房怿 刘洪霞 黄钰涵 苗露阳 申岱[1] FANG Yi;LIU Hongxia;HUANG Yuhan;MIAO Luyang;SHEN Dai(Department of Anesthesiology,the Stomatology Hospital of Tianjin Medical University,China,300070)

机构地区：[1]天津医科大学口腔医院麻醉科,300070

出　　处：《实用口腔医学杂志》2024年第1期87-90,共4页Journal of Practical Stomatology

摘　　要：目的:探讨心率变异(HRV)分析评价小剂量经鼻喷雾右美托咪定对颌面外科老年患者术前焦虑和气管插管应激反应的影响。方法:按照随机数字表法将口腔颌面外科择期手术的患者60例分为2组(n=30)。右美托咪定组(D组)术前经鼻喷雾右美托咪定0.5μg/kg;对照组(C组)等量生理盐水,均采用静吸复合麻醉。比较两组患者术前(T0)、入室(T1)及气管插管(T2)时的血流动力学、心率变异性指标、镇静评分及BIS值变化。结果:T1时,D组与C组Ramsay评分分别为2.8±0.7和1.1±0.3,BIS值分别为87.3±6.1和97.4±0.5,SD1分别为20.9±7.0和15.4±5.4,SDNN分别为30.9±6.6和37.1±7.0,LF/HF分别为1.3±0.3和2.6±0.4(P<0.01)。T2时,D组与C组SD1分别为10.4±3.5和7.7±3.1,SDNN分别为59.2±6.5和70.1±7.1,LF/HF分别为5.1±0.5和7.5±0.5(P<0.01)。结论:右美托咪定小剂量鼻腔喷雾能够有效缓解颌面外科老年患者术前焦虑并且可以减小气管插管应激反应。Objective:To study the effects of low-dose dexmedetomidine via nasal spray on preoperative anxiety and tracheal intubation induced stress response in elderly patients with maxillofacial surgery using heart rate variability(HRV).Methods:60 elderly patients underwent maxillofacial surgery were randomly divided into the dexmedetomidine group(group D)and the control group(group C).Patients in the group D were treated with nasal spray of dexmedetomidine at 45 min preoperatively.Those in the group C were given the same dose of normal saline spray at the same time.All patients were given intravenous combined with inhalation general anesthesia.The hemodynamics,HRV index,sedation score and BIS value of the 2 groups of patients were compared at 3 time points,before operation(T0),entrance(T1)and tracheal intubation(T2)respectively.Results:At T1,the average score of Ramsay in group D and group C was 2.8±0.7 and 1.1±0.39,BIS 87.3±6.1 and 97.4±0.5,SD120.9±7.0 and 15.4±5.4,SDNN 30.9±6.6 and 37.1±7.0,LF/HF 1.3±0.3 and 2.6±0.4,respectively(P<0.01).At T2,the average score of SD1 in group D and group C was 10.4±3.5 and 7.7±3.1,SDNN 59.2±6.5 and 70.1±7.1,LF/HF 5.1±0.5 and 7.5±0.5,respectively(P<0.01).Conclusion:Low-dose dexmedetomidine nasal spray can effectively relieve the preoperative anxiety of elderly patients in maxillofacial surgery and reduce the stress response of tracheal intubation.

关 键 词：老年患者 右美托咪定 经鼻给药 术前焦虑 心率变异性 

分 类 号：R782.05[医药卫生—口腔医学]