摘要
目的探讨在胃癌根治性切除手术中右美托咪定辅助全身麻醉对患者围麻醉期血流动力学、麻醉药用量及术后镇静镇痛的影响。方法选取胃癌患者50例,随机分成实验组和对照组,实验组在麻醉诱导前静脉泵注右美托咪定,对照组输注等量的生理盐水。记录手术过程中探查时及拔管后即刻的心率、平均动脉压、脑电双频指数,切皮时、注药前、气管插管前即刻、麻醉诱导前、麻醉时间、插管后1 min、瑞芬太尼和丙泊酚两个药物的用量、手术后1 h时和4 h时的视觉模拟和镇静评分。结果麻醉诱导前,实验组脑电双频指数显著低于对照组(P<0.01);在麻醉诱导时、插管后1 min、切皮时、探查时、拔管后即刻时,实验组的平均动脉血压显著下降(P<0.05),心率显著减缓(P<0.01)。实验组中瑞芬太尼和丙泊酚的用量均显著小于对照组。实验组术后1、4 h的镇静评分显著高于对照组,视觉模拟评分显著低于对照组(P<0.05)。结论右美托咪定能够在气管插管时、全身麻醉诱导时减轻血流动力学的变化并维持其稳定。
Objective To explore influence of dexmedetomidine-assisted general anesthesia on hemodynamics, anesthetic dosage and postoperative sedation and analgesia in patients with radical gastrectomy for gastric cancer. Methods A total of 50 patients with gastric cancer were randomly di- vided into experimental group and control group. The experimental group was treated with dexmedeto- midine before anesthesia induction, while control group was treated with the same volume of normal sa- line. Heart rate, mean arterial pressure, bispectral index were recorded at the time points of explora- tion, immediately after extubation, skin incision, before injection, immediately before intubation, be- fore induction of anesthesia, duration of anesthesia, 1 rain after intubation, and doses of remifentanil and propofolwere compared, and VAS and sedation score 1 and 4 h were compared. Results Before induction of anesthesia, bispectral index of the experimental group was significantly lower than the con- trol group （P 〈 0.01 ）. At the time points of induction of general anesthesia, 1 min after intubation, skin incision, exploration, extubation, the mean arterial blood pressure in experimental group de- creased significantly （P 〈 0.05 ）, and the heart rate reduced significantly （P 〈 0.01 ）. The dosages of remifentanil and propofol in the experimental group were significantly lower than those in the control group. The sedation scores 1 and 4 h in the experimental group were significantly higher than the con- trol group, and the VAS score was significantly lower than the control group （P 〈 0.05 ）. Conclusion Dexmedetomidine can reduce the hemodynamic changes and maintain the stability of the patients during tracheal intubation and general anesthesia induction.
出处
《实用临床医药杂志》
CAS
2017年第11期87-89,93,共4页
Journal of Clinical Medicine in Practice
基金
国家科技支撑计划项目(2012BAI52B03)
关键词
胃癌
右美托咪定
镇静止痛
麻醉药用量
血流动力学
gastric cancer
dexmedetomidine
sedative and analgesic
anesthetic dos- age
hemodynamics
