地氟烷对非心脏手术患者围手术期心肌损伤的预防价值研究  

A Study on the Preventive Value of Desflurane for Perioperative Myocardial Injury in Non Cardiac Surgery Patients

作　　者：王楠楠 马建新 丁刘欣[1] WANG Nannan;MA Jianxin;Ding Liuxin(The First Affiliated Hospital of Nanyang Medical College,Nanyang Henan 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院,河南南阳473000

出　　处：《药品评价》2024年第8期992-995,共4页Drug Evaluation

摘　　要：目的观察地氟烷对非心脏手术患者围手术期心肌损伤的预防价值。方法本研究为前瞻性研究,研究对象为南阳医学高等专科学校第一附属医院2022年1月至2023年8月期间收治的99例非心脏手术患者,应用电脑随机分组法将入组患者列为常规组(49例)和地氟烷组(50例)。常规组予以常规全身麻醉,地氟烷组采用地氟烷辅助全身麻醉,比较两组术后镇痛、镇静效果,心肌损伤情况,手术应激情况及麻醉安全性。结果在不同麻醉方案下,地氟烷组术后1 h、3 h、5 h的视觉模拟疼痛量表(VAS)评分均低于常规组;地氟烷组术后1 h、3 h、5 h的Ramsay镇静(RSS)评分均高于常规组;地氟烷组的术后肌红蛋白(MYO)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)均低于常规组;地氟烷组的去甲肾上腺素(NE)、皮质醇(Cor)、血管紧张素Ⅱ(AngⅡ)均低于常规组,差异具有统计学意义(P<0.05)。地氟烷组的麻醉相关不良反应发生率8.00%与常规组4.08%比较,差异无统计学意义(P>0.05)。结论地氟烷辅助全身麻醉能增强非心脏手术患者的术后镇痛、镇静效果,可在不增加麻醉风险同时,有效减轻手术应激并预防心肌损伤。Objective Observation of the preventive value of desflurane on perioperative myocardial injury in non cardiac surgery patients.Methods This study was a prospective study,with 99 non cardiac surgery patients admitted to The First Affiliated Hospital of Nanyang Medical College from January 2022 to August 2023.The enrolled patients were randomly divided into a conventional group(49 cases)and a desflurane group(50 cases)using computer randomization.The conventional group received routine general anesthesia,while the desflurane group received desflurane assisted general anesthesia.The postoperative analgesic and sedative effects,myocardial injury,surgical stress and anesthesia safety of the two groups of patients were compared.Results Under different anesthesia regimens,the VAS scores of the desflurane group at 1 hour,3 hours,and 5 hours postoperatively were lower than the conventional group;the RSS scores of the desflurane group at 1 hour,3 hours,and 5 hours postoperatively were higher than the conventional group;the postoperative MYO,CK-MB,and LDH of the desflurane group were lower than the conventional group;the NE,Cor,and AngⅡof the desflurane group were lower than the conventional group(P<0.05).The incidence of anesthesia related side effects in the desflurane group was 8.00%,which was similar to 4.08%in the conventional group(P>0.05).Conclusion Desflurane assisted general anesthesia can enhance postoperative analgesia and sedation in non cardiac surgery patients,effectively reducing surgical stress and preventing myocardial injury without increasing anesthesia risk.

关 键 词：非心脏手术 地氟烷 全身麻醉 心肌损伤 麻醉安全性 

分 类 号：R614[医药卫生—麻醉学]