摘要
目的探讨右美托咪定对腹腔镜行结直肠癌手术老年患者术后疼痛及应激反应的影响.方法选择2019年6月至2020年12月在我院行腹腔镜下结直肠癌根治术老年患者150例,按照随机数字表法分成两组,对照组(75例)与研究组(75例),研究组麻醉诱导前静脉泵注右美托咪定0.5μg/kg,时间10 min,并维持0.5μg/kg/h至手术结束前30 min停止,对照组泵注等容量生理盐水,比较两组患者各时间点心率、血压、术后疼痛与应激反应指标.结果T1(给药后10 min)、T2(气管插管后即刻)、T3(气腹后30 min时)、T4(出手术室时)时研究组平均动脉压、心率明显低于对照组(均P<0.05);T2、T3、T4时研究组去甲肾上腺素、肾上腺素浓度较对照组降低(均P<0.05);T4、T5(术后6 h)时研究组患者疼痛评分低于对照组(P<0.05);研究组术中舒芬太尼用量[(65.5±7.0)μg和(76.2±7.6)μg,t=8.968、P=0.000]、术后24 h镇痛泵按压次数[(6.3±2.3)次和(9.5±3.0)次,t=7.331、P=0.000]、麻醉复苏室停留时间[(23.4±4.0)min和(30.2±5.7)min,t=8.457、P=0.000]均明显少于对照组.结论右美托咪定用于老年患者腹腔镜行结直肠癌手术可减少舒芬太尼用量与麻醉复苏室停留时间、改善术后疼痛评分、降低应激反应,值得推广借鉴.
Objective To investigate the effects of Dexmedetomidine on postoperative pain and stress response in elderly patients undergoing laparoscopic colorectal cancer surgery.Methods A total of 150 elderly patients who had undergone laparoscopic radical resection of colorectal cancer in our hospital from June 2019 to December 2020 were divided into two groups using the random number table method,the control group(n=75)and the study group(n=75).In the study group,Dexmedetomidi ne 0.5 ptg/kg was injected intravenously over 10 min before in duction of anesthesia and maintained at 0.5/ig/kg h until 30 min before the end of surgery.Changes in heart rate,mean arterial pressure,postoperative pain and stress response index scores were compared between the two groups.Results The MAP and HR in the study group at T1(10 min after administration).T2(immediately after endotracheal intubation),T3(30 min after pneumoperitoneum)and T4(leaving the operating room)were significantly lower than in the control group(P<0.05);The concentrations of norepinephrine and epinephrine in the study group were lower than those in the control group at T2.T3 and T4(all P<Z0.05);Pain scores of patients in the study group were lower than those in the control group at T4 and T5(P<C0.05);Compared with the control group.the study group used less intraoperative Sufentanil[(65.5±7.0)μg vs.(76.2±7.6)vg,/=8.968.P=0.000],needed a lower number of PC1A compressions 24 h after surgery[(6.3±2.3)us.(9.5±3.0),t=7.331,P=0.000]and had a shorter length of PACU stay[(23.4±4.0)min-us.(30.2±5.7)min.t=8.457.P=0.000].Conclusions Dexmedetomidine used in laparoscopic colorectal cancer surgery in elderly patients can reduce the use of sufentanil and the length of PACU stay time.improve postoperative pain scores and reduce stress response»and therefore should be recommended.
作者
巫绍汝
吴婷婷
孙艳
金晓菲
彭科
嵇富海
Wu Shaoru;Wu Tingting;Sun Yan;Jin Xiaofei;Peng Ke;Ji Fuhai(Department of Anesthesiology,the First Affiliated Hospital of Soochow Universiy,Suzhou 215006,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2021年第11期1417-1420,共4页
Chinese Journal of Geriatrics
基金
国家自然科学青年基金项目(81601659)。
