不同剂量右美托咪定联合尼卡地平全麻在伴高血压患者腹腔镜胆囊切除术中的应用观察  

Application of different doses of dexmedetomidine combined with nicardipine general anesthesia in laparoscopic cholecystectomy for patients with hypertension

作　　者：李翠玲 Li Cui-ling(Department of Anesthesiology,Guangxin District Second People's Hospital,Shangrao 334100,Jiangxi,China)

机构地区：[1]上饶市广信区第二人民医院麻醉科,江西上饶334100

出　　处：《四川生理科学杂志》2025年第2期307-309,405,共4页

摘　　要：目的:探讨不同剂量右美托咪定(Dexmedetomidine,DEX)联合尼卡地平全麻在伴高血压患者腹腔镜胆囊切除术(Laparoscopic cholecystectomy,LC)中的应用效果。方法:选取60例于2019年1月至2024年6月在本院行DEX联合尼卡地平全麻的伴高血压LC患者为研究对象,按奇偶数法分为低剂量组及高剂量组(均n=30)。所有患者均行DEX联合尼卡地平全身麻醉,低剂量组及高剂量组分别泵入0.5、1.0μg·(kg·h)^(-1)DEX直至手术结束。对比各组麻醉指标;给药前(T1)、给药后即刻(T2)、拔管后即刻(T3)、拔管后5 min(T4)时患者平均动脉压(Mean arterial pressure,MAP)及心率(Heart rate,HR);术后12 h及24 h简易精神状态量表评分(Mini mental status exam,MMSE)及不良反应发生率。结果:两组苏醒时间、苏醒后即刻视觉模拟评分(Visual analog scale,VAS)无统计学差异(P>0.05);高剂量组拔管时间长于低剂量组(P<0.05);T1、T2时低剂量组MAP、HR低于高剂量组(P<0.05);两组术后12 h及24 h MMSE评分均较术前明显降低(P<0.05),其中高剂量组更为显著;两组不良反应发生率无统计学差异(P>0.05)。结论:将0.5μg·(kg·h)^(-1)DEX联合尼卡地平全麻应用于伴高血压LC患者具有良好镇痛效果,能够加快患者拔管,有效维持血压稳定,有利于患者术后认知功能恢复且具有一定的安全性,值得临床应用。Objective:To explore the application effect of different doses of dexmedetomidine(DEX)combined with nicardipine general anesthesia in patients with hypertension after laparoscopic cholecystectomy(LC).Methods:A total of 60 patients with hypertension who underwent LC under general anesthesia(DEX combined with nicardipine)in the hospital were enrolled as the research objects between January 2019 and June 2024.According to odd-even method,they were divided into low-dose group(n=30)and high-dose group(n=30).The low-dose group and high-dose group were given 0.5 or 1.0μg·(kg·h)^(-1) DEX till end of the surgery,respectively.The anesthesia indexes,mean arterial pressure(MAP)and heart rate(HR)before administration(T1),immediately after administration(T2),immediately after extubation(T3)and at 5 min after extubation(T4),scores of mini-mental state examination(MMSE)at 12 hours and 24 hours after surgery,and incidence of adverse reactions in different groups were compared.Results:There was no significant difference in awaking time or score of visual analogue scale(VAS)immediately after recovery between the two groups(P>0.05).The extubation time in high-dose group was longer than that in low-dose group(P<0.05).At T1 and T2,MAP and HR in low-dose group were lower than those in high-dose group(P<0.05).At 12 hours and 24 hours after surgery,MMSE scores were significantly decreased in both groups(P<0.05),which were lower in high-dose group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:0.5μg·(kg·h)^(-1) DEX combined with nicardipine for general anesthesia has good analgesic effect in LC patients with hypertension,which can accelerate extubation,effectively maintain stable blood pressure and is conducive to postoperative recovery of cognitive function,with certain safety.

关 键 词：右美托咪定 尼卡地平 高血压 腹腔镜胆囊切除术 

分 类 号：R614[医药卫生—麻醉学]