摘要
目的探讨不同剂量右美托咪定联合地佐辛对肺癌根治术患者全麻苏醒期躁动及血流动力学的影响。方法对2014年10月—2016年12月于鄂州市鄂钢医院行肺癌根治术治疗的128例肺癌临床资料进行回顾性分析,根据给药方法分为A、B、C和D组,每组32例。4组术前均静脉注射地佐辛0.05 mg/kg,A组给予丙泊酚静脉注射,B、C、D组在A组基础上分别给予右美托咪定0.25、0.50和1.00μg/kg,继以0.4μg/(kg·h)持续泵注至手术结束前。记录并比较4组不同时间点血流动力学变化及全麻苏醒期躁动和心动过缓情况。结果 A、B组T_3、T_4时点平均动脉压(MAP)高于T_1时点,但B组低于A组(P<0.05);C组和D组在T_2、T_3和T_4时点MAP水平低于T_1时点和B组,且D组降低更明显(P<0.05);与A组比较,C、D组T_2、T_3和T_4时点MAP水平均较低(P<0.05)。A、B组T_3、T_4时点心率较T_1时点增快,且A组高于B组(P<0.05);C、D组T_2、T_3和T_4时点心率较T_1时点减慢,且D组减慢更明显,与A、B组比较,T_2、T_3和T_4时点心率降低(P<0.05)。D组术后苏醒期躁动程度最轻(P<0.05)。结论肺癌根治术术中给予高剂量右美托咪定联合地佐辛可保持其血流动力学稳定,减少苏醒期躁动,且具有一定安全性。
Objective To investigate effects of different dosages of Dexmedetomidine combined with Dezocine on restlessness and hemodynamics of lung cancer patients with radical correction under general anesthesia.Methods Clinical data of lung cancer 128 patients with radical correction during October 2014 and December 2016 was retrospectively analyzed,and the patients were divided into group A(n=32),group B(n=32),group C(n=32)and group D(n=32)according to medicine doses.In 4 groups,intravenous injection of 0.05 mg/kg Dezocine was given before surgery,and group A was treated with Propofol by intravenous injection,and intravenous injection of 0.25,0.50 and 1.00μg/kg Dexmedetomidine were respectively performed in group B,C and D before cannula of anesthesia induction,and continuous injection with 0.4μg/(kg·h)dose was given till to the end of surgery by continuing pump.Different time points of hemodynamic changes and conditions of restlessness and bradycardia during general anesthesia recovery period were recorded and compared.Results Mean arterial pressure(MAP)levels at T3 and T4 were significantly higher than those at T1 in group A and B,and the levels in group B were significantly lower than those in group A(P<0.05);in group C and D,MAP levels at T2,T3 and T4 were significantly lower than those at T1 in group C and D and at T2,T3 and T4 in group B,and the decreased levels in group D were more obviously(P<0.05),and MAP levels at T2,T3 and T4 in group C and D were significantly lower than those in group A(P<0.05).Heart rate(HR)levels at T3 and T4 were significantly increased compared with those at T1 in group A and B,and the levels in group A were significantly higher than those in group B(P<0.05);HR levels at T2,T3 and T4 were significantly lower than those at T1 in group C and D,and the levels at T2,T3 and T4 in group D were significantly lower than those in group A,B and C(P<0.05).Postoperative restlessness degree in group D was the lightest one(P<0.05).Conclusion Intraoperative high-dose Dexmedetomidine combined with Dezocine may well maintain its hemodynamics stability and reduce its body's restlessness during analepsia stage in lung cancer patients with safety.
作者
杨俊
YANG Jun(Department of Anaesthesiology,Egang Hospital of Ezhou City,Ezhou,Hubei 436000,China)
出处
《解放军医药杂志》
CAS
2018年第4期92-95,99,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
湖北省自然科学基金资助项目(2014-04710)
关键词
肺肿瘤
右美托咪定
地佐辛
麻醉
Lung cancer
Dexmedetomidine
Dezocine
Anesthesia
