右美托咪定复合瑞芬太尼对腹腔镜下胆囊切除术患者镇静效果及应激反应的影响  

Influences of dexmedetomidine combined with remifentanil on sedation effect and stress response in patients undergoing laparoscopic cholecystectomy

作　　者：李莎[1] 范斌 王俊平 段春宇 张琪 LI Sha;FAN Bin;WANG Junping;DUAN Chunyu;ZHANG Qi(Anesthesiology Department,the First Affiliated Hospital of Northwest University/Xi'an No.1 Hospital,Xi'an 710002;General Surgery Department,the First Affiliated Hospital of Northwest University/Xi'an No.1 Hospital,Xi'an 710002;Anesthesiology Department,Chest Hospital Affiliated to Northwest University/Xi'an Chest Hospital,Xi'an 710100;Anesthesiology Department,Xi'an Purui Eye Hospital,Xi'an 710068,China)

机构地区：[1]西北大学附属第一医院/西安市第一医院麻醉科,陕西西安710002 [2]西北大学附属第一医院/西安市第一医院普通外科,陕西西安710002 [3]西北大学附属胸科医院/西安市胸科医院麻醉科,陕西西安710100 [4]西安市普瑞眼科医院麻醉科,陕西西安710068

出　　处：《临床医学研究与实践》2025年第8期86-89,共4页Clinical Research and Practice

摘　　要：目的探讨右美托咪定复合瑞芬太尼对腹腔镜下胆囊切除术患者镇静效果及应激反应的影响。方法将2021年1月至2022年1月收治的80例腹腔镜下胆囊切除术患者随机将其分为对照组和观察组,各40例。对照组实施丙泊酚复合瑞芬太尼麻醉,观察组实施右美托咪定复合瑞芬太尼麻醉。比较两组的麻醉效果。结果插管即刻(T_(1))、气腹后20 min(T_(2))、拔管后5 min(T_(3)),观察组的Ramsay镇静评分高于对照组(P<0.05)。T_(1)、T_(2)、T_(3),观察组的平均动脉压(MAP)、心率(HR)高于对照组(P<0.05)。T_(1)、T_(2)、T_(3),观察组的皮质醇(Cor)、去甲肾上腺素(NE)水平低于对照组(P<0.05)。观察组的麻醉不良事件总发生率低于对照组(P<0.05)。结论右美托咪定复合瑞芬太尼可提高腹腔镜下胆囊切除术患者的镇静效果,维持血流动力学稳定,减轻应激反应,降低麻醉不良事件发生率。Objective To investigate the influences of dexmedetomidine combined with remifentanil on sedation effect and stress response in patients undergoing laparoscopic cholecystectomy.Methods A total of 80 patients undergoing laparoscopic cholecystectomy from January 2021 to January 2022 were randomly divided into control group and observation group,with 40 cases in each group.The control group was anesthetized with propofol combined with remifentanil,and the observation group was anesthetized with dexmedetomidine combined with remifentanil.The anesthetic effects of the two groups were compared.Results Immediate intubation(T_(1)),20 min after pneumoperitoneum(T_(2)),and 5 min after extubation(T_(3)),the Ramsay sedation score of the observation group was higher than that of the control group(P<0.05).At T_(1),T_(2) and T_(3),the mean arterial pressure(MAP)and heart rate(HR)of the observation group were higher than those of the control group(P<0.05).At T_(1),T_(2) and T_(3),the levels of cortisol(Cor)and norepinephrine(NE)in the observation group were lower than those in the control group(P<0.05).The total incidence of adverse events of anesthesia in the observation group was lower than that in the control group(P<0.05).Conclusion Dexmedetomidine combined with remifentanil can improve the sedative effect of patients undergoing laparoscopic cholecystectomy,maintain hemodynamic stability,reduce stress response,and reduce the incidence of adverse events of anesthetic.

关 键 词：右美托咪定 瑞芬太尼 腹腔镜下胆囊切除术 镇静效果 应激反应 

分 类 号：R657.4[医药卫生—外科学]