全麻诱导前静脉泵注右美托咪定在老年髋部手术患者中的应用  

Application of Anterior Intravenous Pump With Dexmedetomidine Induced by General Anesthesia in Elderly Patients Undergoing Hip Surgery

作　　者：钟启钊 刘丽贤 蔡瑞卿 谢长春 ZHONG Qizhao;LIU Lixian;CAI Ruiqing;XIE Changchun(Department of Anesthesiology,Liwan Central Hospital of Guangzhou,Guangzhou Guangdong 510000,China)

机构地区：[1]广州市荔湾中心医院麻醉科,广东广州510000

出　　处：《中国卫生标准管理》2024年第21期129-132,共4页China Health Standard Management

摘　　要：目的探究全麻诱导前静脉泵注右美托咪定在老年髋部手术患者中的应用效果。方法选取广州市荔湾中心医院2022年7月—2023年1月期间收治的89例老年髋部手术患者作为研究对象。根据随机数字表法分为观察组(n=45)与对照组(n=44)。观察组患者在全麻诱导前10 min静脉泵注右美托咪定1.0μg/kg,对照组患者于全麻诱导前10 min静脉泵注0.9%氯化钠溶液1.0μg/kg。比较2组患者围手术期[静脉泵注右美托咪定或生理盐水使用前(T0)、负荷剂量输注后(T1)、手术完成时(T2)、进入麻醉恢复室(post anesthesia care unit,PACU)后1 h(T3)、术后1 d(T4)]无创心排血量(noninvasive cardiac output,NICO)、手术时间、术中出血量、术中液体输注量以及不良反应。结果观察组患者在T1、T2时的NICO分别为(4.16±0.34)L/min、(4.39±0.45)L/min,每搏输出量(stroke volume,SV)分别为(59.86±10.74)mL、(61.89±8.75)mL,以及心指数(cardiac index,CI)分别为(3.46±0.32)min·m^(2)、(3.69±0.37)min·m^(2),均高于对照组,差异均有统计学意义(P<0.05);2组患者手术时间、术中出血量、液体输注量比较,差异无统计学意义(P>0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论全麻诱导前静脉泵注右美托咪定对老年髋部手术患者围手术期的NICO影响较小,且不会增加液体输注量,具备安全性。Objective To investigate the effect of anterior venous pump injection of dexmedetomidine induced by general anesthesia in elderly patients undergoing hip surgery.Methods A total of 89 elderly patients with hip surgery admitted to Liwan Central Hospital of Guangzhou from July 2022 to January 2023 were selected as the research objects.According to the random number table method,45 patients were divided into observation group and 44 patients were divided into control group.Patients in the observation group received dexmedetomidine 1.0μg/kg intravenously 10 min before induction of general anesthesia,while patients in the control group received 0.9%sodium chloride solution 1.0μg/kg intravenously 10 min before induction of general anesthesia.The noninvasive cardiac output(NICO),operation time,intraoperative blood loss,intraoperative fluid infusion volume,and adverse reactions were compared between the two groups during the perioperative period[before intravenous infusion of dexmedetomidine or normal saline(T0),after loading dose infusion(T1),at the completion of surgery(T2),1 h after entering the post anesthesia care unit(T3),and 1 day after surgery(T4)].Results NICO of the observation group at T1 and T2 were(4.16±0.34)L/min and(4.39±0.45)L/min,respectively.Stroke volume(SV)were(59.86±10.74)mL,(61.89±8.75)mL,and cardiac index(CI)were(3.46±0.32)min·m^(2),(3.69±0.37)min·m^(2) higher than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in operation time,intraoperative blood loss and fluid infusion between the two groups(P>0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Intravenous infusion of dexmedetomidine before induction of general anesthesia has little effect on NICO in elderly patients undergoing hip surgery during the perioperative period,and it does not increase the volume of fluid infusion,which is safe.

关 键 词：右美托咪定 髋部手术 无创心排量 液体输注量 全麻诱导 静脉泵注 

分 类 号：R614.2[医药卫生—麻醉学]