右美托咪定静脉输注联合舒芬太尼复合盐酸罗哌卡因蛛网膜下腔阻滞对老年经尿道前列腺电切术患者应激反应的影响  

Effect of Dexmedetomidine Intravenous Infusion Combined with Sufentanil and Ropivacaine Hydrochloride Subarachnoid Block on Stress Response in Elderly Patients Undergoing Transurethral Electrocision of the Prostate

作　　者：邓媛 吴惠卿 张朝阳 DENG Yuan;WU Huiqing;ZHANG Chaoyang(Department of Anaesthesia,People's Hospital of Ruijin City,Ruijin 342500,China;不详)

机构地区：[1]瑞金市人民医院麻醉科,江西瑞金342500

出　　处：《中国医学创新》2025年第5期65-68,共4页Medical Innovation of China

摘　　要：目的:探讨右美托咪定静脉输注联合舒芬太尼复合盐酸罗哌卡因蛛网膜下腔阻滞对老年经尿道前列腺电切术患者应激反应的影响。方法:选取2022年2月-2024年2月于瑞金市人民医院行经尿道前列腺电切术的老年患者104例作为研究对象,并采用随机数字表法分为对照组(C组,n=52)和试验组(D组,n=52)。C组接受舒芬太尼复合盐酸罗哌卡因蛛网膜下腔阻滞,D组在C组基础上加用右美托咪定。比较两组术后2、24h的视觉模拟评分法(VAS)评分和Ramsay镇静评分、血清皮质醇(Cor)和促肾上腺皮质激素(ACTH)水平,以及不良反应发生率。结果:两组术后24 h VAS评分均高于术后2 h,差异均有统计学意义(P<0.05);D组术后2、24 h VAS评分均低于C组,差异均有统计学意义(P<0.05)。D组术后2 h Ramsay镇静评分高于C组,差异有统计学意义(P<0.05)。术前,C组和D组血清Cor和ACTH比较,差异均无统计学意义(P>0.05);术后24 h,两组血清Cor、ACTH均升高,D组血清Cor和ACTH均低于C组,差异均有统计学意义(P<0.05)。D组和C组术后不良反应发生率(17.31%vs 11.54%)比较,差异无统计学意义(P>0.05)。结论:右美托咪定静脉输注联合舒芬太尼复合盐酸罗哌卡因蛛网膜下腔阻滞能够有效减轻老年经尿道前列腺电切术患者的应激反应和术后疼痛,且不增加不良反应发生情况。Objective:To investigate the effect of Dexmedetomidine intravenous infusion combined with Sufentanil and Ropivacaine Hydrochloride subarachnoid block on stress response in elderly patients undergoing transurethral electrocision of the prostate.Method:A total of 104 elderly patients who underwent transurethral electrocision of the prostate in People's Hospital of Ruijin City from February 2022 to February 2024 were selected as the study objects,and they were divided into control group(group C,n=52)and experimental group(group D,n=52)by random number table method.Group C received Sufentanil and Ropivacaine Hydrochloride subarachnoid block,and group D received Dexmedetomidine on the basis of group C.Visual analogue scale(VAS)score and Ramsay sedation score 2 and 24 h after surgery,serum cortisol(Cor)and adrenocorticotropic hormone(ACTH)levels,and the incidence of adverse reactions were compared between the two groups.Result:The VAS scores 24 h after surgery in both groups were higher than those 2 h after surgery,the differences were statistically significant(P<0.05).The VAS scores 2 and 24 h after surgery in group D were lower than those in group C,the differences were statistically significant(P<0.05).Ramsay sedation scores 2 h after surgery in group D was higher than that in group C,the difference was statistically significant(P<0.05).Before surgery,there were no significant differences in serum Cor and ACTH between group C and group D(P>0.05).24 h after surgery,serum Cor and ACTH were increased in both groups,and those in group D were lower than those in group C,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative adverse reactions between group D and group C Medical Innovation of China Vol.22,No.5 February,2025(17.31%vs 11.54%)(P>0.05).Conclusion:Dexmedetomidine intravenous infusion combined with Sufentanil and Ropivacaine Hydrochloride subarachnoid block can effectively reduce the stress response and postoperative pain in elderly patients u

关 键 词：右美托咪定 舒芬太尼 盐酸罗哌卡因 蛛网膜下腔阻滞 经尿道前列腺电切术 应激 反应 老年患者 

分 类 号：R614[医药卫生—麻醉学]