右美托咪定联合盐酸戊乙奎醚在腹腔镜手术全身麻醉患者中的应用效果  

Application effects of dexmedetomidine combined with pentylequidine hydrochloride in patients undergoing laparoscopic surgery under general anesthesia

作　　者：刘曦楠 王尚昆 赵艳春 LIU Xi′nan;WANG Shangkun;ZHAO Yanchun(Anesthesiology Department of Zhangjiakou First Hospital,Zhangjiakou 075000,Hebei Province,China)

机构地区：[1]张家口市第一医院麻醉科,河北张家口075000

出　　处：《新乡医学院学报》2025年第1期62-68,共7页Journal of Xinxiang Medical University

摘　　要：目的探讨右美托咪定联合盐酸戊乙奎醚在腹腔镜手术全身麻醉患者中的应用效果。方法选择2022年6月至2023年3月张家口市第一医院收治的92例行腹腔镜手术全身麻醉的患者为研究对象。根据麻醉方案不同将患者分为对照组和观察组,每组46例。2组患者采用相同的麻醉诱导方案,即静脉注射丙泊酚1~2 mg·kg^(-1)、舒芬太尼0.5~1.0μg·kg^(-1)、罗库溴铵0.6 mg·kg^(-1),观察组患者于麻醉诱导前给予右美托咪定联合盐酸戊乙奎醚,对照组患者麻醉诱导前给予等体积和相同滴注速度的生理盐水。分别于镇静前(T_(0))、镇静后90 min(T_(1))、停药后3 h(T_(2)),使用彩色多普勒超声仪检测2组患者椎动脉和颈内动脉的平均流速和血管直径,计算脑血流量(CBF);分别于T_(0)、T_(1)时使用血气分析仪检测2组患者动脉血氧含量和静脉血氧含量,计算脑氧代谢率等值(CMRe);观察并记录T_(0)、T_(1)、T_(2)时2组患者平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO_(2));分别在T_(0)、T_(1)、T_(2)时,采用酶联免疫吸附法检测2组患者血清神经元特异性烯醇化酶(NSE)、S100β蛋白水平;采用Riker镇静躁动评分标准(SAS)评估T_(0)、T_(1)、T_(2)时2组患者的镇静效果;比较2组患者术后不良反应发生率。结果T_(0)时,2组患者的CBF、CMRe比较差异均无统计学意义(P>0.05)。2组患者T_(1)时的CBF、CMRe均显著高于T_(0)时(P<0.05),2组患者T_(2)时的CBF显著高于T_(0)时(P<0.05);2组患者T_(2)时与T_(1)时的CBF比较差异无统计学意义(P>0.05)。T_(1)时,观察组患者的CBF、CMRe显著低于对照组(P<0.05);T_(2)时,观察组患者的CBF显著低于对照组(P<0.05)。T_(0)时,2组患者的MAP、HR、SpO_(2)比较差异均无统计学意义(P>0.05)。对照组患者T_(1)、T_(2)时的HR均显著高于T_(0)时,T_(2)时的HR显著低于T_(1)时(P<0.05)。观察组患者T_(1)、T_(2)时的HR均显著低于T_(0)时,T_(2)时的HR显著低于T_(1)时(P<0.0Objective To investigate the application effects of dexmedetomidine combined with penehyclidine hydrochloride in patients undergoing laparoscopic surgery under general anesthesia.Methods Ninety-two patients undergoing laparoscopic surgery under general anesthesia in Zhangjiakou First Hospital from June 2022 to March 2023 were selected.They were divided into an observation group and a control group according to the anesthesia scheme,with 46 cases in each group.Both groups of patients adopted the same anesthesia induction program,namely,intravenous injection of 1-2 mg·kg^(-1) propofol,0.5-1.0 mg·kg^(-1) sulfentanil,and 0.6 mg·kg^(-1) rocuronium bromide.Patients in the observation group were given dexmedetomidine combined with penehyclidine hydrochloride before anesthesia induction,while those in the control group were given physiological saline of the same volume and at the same drip rate before induction.Before sedation(T_(0)),90 min after sedation(T_(1))and 3 h after drug withdrawal(T_(2)),the average velocity and vessel diameter of the vertebral artery and internal carotid artery were detected by color doppler ultrasound.The cerebral blood flow(CBF)was also calculated.Both the arterial and venous oxygen content was detected by a blood gas analyzer at T_(0) and T_(1),and the cerebral metabolic rate equivalent(CMRe)was calculated.The mean arterial pressure(MAP),heart rate(HR)and pulse oxygen saturation(SpO_(2))levels were observed and recorded at T_(0),T_(1) and T_(2).Serum levels of neuron-specific enolase(NSE)and S100βproteins were detected by enzyme-linked immunosorbent assay at T_(0),T_(1) and T_(2).The Riker sedation and restfulness score(SAS)was used to evaluate the sedation effect in the two groups at T_(0),T_(1) and T_(2).The incidence of postoperative adverse reactions was compared between the two groups.Results There was no significant difference in CBF and CMRe of patients between the two groups at T_(0)(P>0.05).The CBF and CMRe at T_(1) were significantly higher than those at T_(0) in both groups(P

关 键 词：腹腔镜手术 右美托咪定 盐酸戊乙奎醚 脑代谢率 脑保护 

分 类 号：R614[医药卫生—麻醉学]