不同剂量右美托咪定联合地佐辛对胸腔镜肺癌根治术患者术后疼痛和认知功能的影响  

Effects of Different Doses of Dexmedetomidine Combined with Dezocine on Postoperative Pain and Cognitive Function in Patients Undergoing Thoracoscopic Lung Cancer Radical Surgery

作　　者：杨煜[1] 刘岷[1] 朱芩芩[1] YANG Yu;LIU Min;ZHU Qinqin(Department of Anesthesiology,Shanghai Huangpu District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200436)

机构地区：[1]上海市黄浦区中西医结合医院麻醉科,上海200436

出　　处：《医学临床研究》2024年第12期1833-1835,1840,共4页Journal of Clinical Research

摘　　要：【目的】探讨不同剂量右美托咪定(Dex)联合地佐辛对胸腔镜肺癌根治术患者术后疼痛和认知功能的影响。【方法】122例肺癌患者,随机分为观察组和对照组,每组61例。观察组予以高剂量(1.2μg/kg)Dex联合地佐辛麻醉,对照组予以低剂量(0.8μg/kg)Dex联合地佐辛麻醉。比较两组患者麻醉不同时刻血流动力学指标水平、术后疼痛评分、术后炎症因子[肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)]水平、术后认知功能及不良反应发生情况。【结果】麻醉前(T 0)、术中气管导管拔除即刻(T 1)及术毕(T 2)时,两组血氧饱和度(SpO 2)水平比较,差异均无统计学意义(P>0.05);T 1、T 2时,两组心率(HR)、平均动脉压(MAP)均低于T 0时(P<0.05),且观察组低于对照组(P<0.05)。两组患者术后6 h及12 h疼痛评分均低于术后1 h(P<0.05),术后12 h疼痛评分均低于术后6 h(P<0.05);且观察组术后1 h、6 h及12 h疼痛评分均低于对照组(P<0.05)。术后,两组患者TNF-α及IL-6水平均低于术前(P<0.05),且观察组低于对照组(P<0.05)。两组患者术前及术后72 h认知功能评分比较,差异均无统计学意义(P>0.05);两组患者术后72 h认知功能评分均高于术前(P<0.05)。两组术后不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】高剂量Dex联合地佐辛用于胸腔镜肺癌根治术麻醉中,较低剂量更有利于降低患者术后疼痛水平及炎症反应程度,对认知功能的损害较小。【Objective】To investigate the effects of different doses of dexmedetomidine(Dex)combined with dezocine on postoperative pain and cognitive function in patients undergoing thoracoscopic lung cancer radical surgery.【Methods】A total of 122 lung cancer patients were randomly divided into the observation group and the control group,with 61 cases in each group.The observation group received high-dose(1.2μg/kg)Dex combined with dezocine anesthesia,while the control group received low-dose(0.8μg/kg)Dex combined with dezocine anesthesia.The hemodynamic levels at different anesthesia time points,postoperative pain responses,levels of inflammatory factors[tumor necrosis factor-alpha(TNF-α)and interleukin-6(IL-6)]after surgery,postoperative cognitive function,and incidence of adverse reactions were compared between the two groups.【Results】At pre-anesthesia(T 0),immediately after endotracheal extubation(T 1),and postoperatively(T 2),there were no statistically significant differences in oxygen saturation(SpO 2)levels between the two groups(P>0.05).At T 1,T 2,both heart rate(HR)and mean arterial pressure(MAP)levels in both groups were lower than at T 0(P<0.05),and the observation group was lower than the control group(P<0.05).The pain scores at 6 hours and 12 hours postoperatively were lower than at 1 hour postoperatively in both groups(P<0.05),and the pain scores at 12 hours postoperatively were lower than at 6 hours postoperatively(P<0.05).Additionally,the observation group had lower pain scores at 1 hour,6 hours,and 12 hours postoperatively compared to the control group(P<0.05).Postoperatively,TNF-αand IL-6 levels in both groups were lower than preoperatively(P<0.05),and the observation group was lower than the control group(P<0.05).There were no statistically significant differences in cognitive function scores between the two groups at 72 hours postoperatively compared to preoperatively(P>0.05).Cognitive function levels in both groups were higher at 72 hours postoperatively compared to preoperatively(P<0.0

关 键 词：肺肿瘤 胸腔镜检查 右美托咪定 环烷类 疼痛 手术后 认知 

分 类 号：R734.2[医药卫生—肿瘤]