右美托咪定预处理复合七氟醚吸入麻醉+超声引导椎旁阻滞对肾脏肿瘤切除术的应用效果  

Application effect of dexmedetomidine pretreatment combined with sevoflurane inhalation anesthesia and ultrasound-guided paraspinal block on renal tumor resection surgery

作　　者：郭辛辛 刘世斌 骆超 GUO Xin-xin;LIU Shi-bin;LUO Chao(Department of Anesthesiology,Linfen People's Hospital,Linfen Shanxi 041000,China;Department of Urology,Linfen People's Hospital,Linfen Shanxi 041000,China)

机构地区：[1]临汾市人民医院麻醉科,山西临汾041000 [2]临汾市人民医院泌尿外科,山西临汾041000

出　　处：《临床和实验医学杂志》2025年第5期557-560,F0003,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省中医药管理局科研课题计划项目(编号:2024ZYYB)。

摘　　要：目的探讨右美托咪定预处理复合七氟醚吸入麻醉+超声引导椎旁阻滞对肾脏肿瘤切除术的应用效果。方法前瞻性选取2021年1月至2024年1月临汾市人民医院收治的66例肾脏肿瘤切除术患者作为研究对象,按照随机数字表法将其分为3组,即对照组、联合麻醉组、超声组,每组各22例。对照组实施七氟醚吸入麻醉,联合麻醉组实施右美托咪定预处理复合七氟醚吸入麻醉,超声组实施右美托咪定预处理复合七氟醚吸入麻醉+超声引导椎旁阻滞。比较3组诱导前(T_(0))、诱导后5 min(T_(1))、气腹时(T_(2))、手术30 min(T_(3))、手术结束即刻(T_(4))的心率、平均动脉压(MAP)变化。比较3组的麻醉效果(拔管时间、苏醒时间、手术时间、定向力恢复时间),术后视觉模拟评分法(VAS)评分,术前、术后12 h的S100β蛋白及肾上腺素变化,并比较3组麻醉期间的不良反应发生情况。结果T_(2)、T_(3)、T_(4)时,对照组、联合麻醉组的心率、MAP水平均较T_(0)时明显升高,差异均有统计学意义(P<0.05),而超声组的心率、MAP较T_(0)时无明显波动;T_(2)、T_(3)、T_(4)时,超声组心率、MAP均低于对照组与联合麻醉组,联合麻醉组心率、MAP均低于对照组,差异均有统计学意义(P<0.05)。超声组手术时间长于对照组、联合麻醉组,拔管时间、苏醒时间、定向力恢复时间均短于对照组、联合麻醉组,差异均有统计学意义(P<0.05)。超声组术后6、12、24 h的VAS评分均低于对照组、联合麻醉组,差异均有统计学意义(P<0.05);对照组与联合麻醉组术后6、12、24 h的VAS评分比较,差异均无统计学意义(P>0.05)。术后12 h,3组患者S100β、肾上腺素水平均较术前升高,差异均有统计学意义(P<0.05)。术后12 h,超声组、联合麻醉组的S100β水平分别为(1.45±0.32)、(1.43±0.37)ng/mL,低于对照组[(2.15±0.42)ng/mL],差异有统计学意义(P<0.05),而超声组与联合麻醉组的S100β水平比较,�Objective To investigate the application effect of dexmedetomidine pretreatment combined with sevoflurane inhalation anesthesia and ultrasound-guided paraspinal block on renal tumor resection.Methods A total of 66 patients with renal tumor resection admitted to Linfen People's Hospital from January 2021 to January 2024 were prospectively selected as the research objects.According to the random number table method,they were divided into three groups:the control group,the combined anesthesia group and the ultrasound group,with 22 cases in each group.The control group received sevoflurane inhalation anesthesia,the combined anesthesia group received dexmedetomidine pretreatment combined with sevoflurane inhalation anesthesia,and the ultrasound group received dexmedetomidine pretreatment combined with sevoflurane inhalation anesthesia and ultrasound-guided paraspinal block.The changes in heart rate and mean arterial pressure(MAP)before induction(T_(0)),5 minutes after induction(T_(1)),during pneumoperitoneum(T_(2)),30 minutes after surgery(T_(3)),and immediately after surgery(T_(4))in three groups were compared,and their anesthesia effects(extubation time,awakening time,surgery time,orientation recovery time),postoperative visual analogue scale(VAS),changes in S100βprotein and adrenaline before and after surgery in three groups were compared,and the adverse reactions during anesthesia in three groups were compared.Results At T_(2),T_(3) and T_(4),the heart rate and MAP levels of the control group and the combined anesthesia group were significantly higher than those at T_(0),and the differences were statistically significant(P<0.05),while the heart rate and MAP of the ultrasound group had no statistically significant fluctuation compared with those at T_(0).At T_(2),T_(3) and T_(4),the heart rate and MAP of the ultrasound group were lower than those of the control group and the combined anesthesia group,and the heart rate and MAP of the combined anesthesia group were lower than those of the control group,the differen

关 键 词：右美托咪定 七氟醚 椎旁阻滞 肾脏肿瘤 生命体征 疼痛程度 不良反应 

分 类 号：R614[医药卫生—麻醉学]