摘要
目的探讨右美托咪定联合酮咯酸氨丁三醇预辅助麻醉用于腹腔镜胆囊切除术(LC)的麻醉效果及对患者应激反应的影响。方法选取医院2016年8月至2017年10月收治行LC的患者100例,按随机数字表法分为对照组和研究组,各50例。两组患者均给予酮咯酸氨丁三醇注射液辅助麻醉,研究组加用盐酸右美托咪定注射液。结果研究组患者气腹后(T3)、切胆时(T4)的心率(HR)、平均动脉压(MAP)均显著高于对照组,手术结束(T5)时的HR和MAP均显著低于对照组(P <0. 05);两组患者术后1 h(T6)、术后6 h(T7)、术后12 h(T8)的视觉模拟评分(VAS)先升后降,且研究组均低于对照组(P <0. 05);研究组Ramsay镇静评分均显著高于对照组(P <0. 05);与入手术室(T1)时比较,两组患者T4和T5时的皮质醇(Cor)、血糖(Glu)及去甲肾上腺素(NE)水平均显著升高,且研究组显著低于对照组(P <0. 05);两组患者不良反应发生率无显著差异(P> 0. 05)。结论 LC患者采用右美托咪定联合酮咯酸氨丁三醇进行预辅助麻醉,麻醉效果较好,可维持血流动力学,减轻机体应激反应,且不增加不良反应。
Objective To investigate the anesthetic effect of dexmedetomidine combined with ketorolac tromethamine for pre-adjuvant anesthesia in laparoscopic cholecystectomy( LC) and its effect on the stress response of patients. Methods Totally 100 patients underwent LC admitted to our hospital from August 2016 to October 2017 were selected and randomly divided into the control group and the study group according to the random number table method,50 cases in each group. The patients in the two groups were given Ketorolac Tromethamine Injection as an adjuvant anesthesia,on this basis,the patients in the study group were given Dexmedetomidine Hydrochloride Injection. Results The heart rate( HR) and mean arterial pressure( MAP) in the study group were significantly higher than those in the control group at the time of pneumoperitoneum( T3),cholecystectomy( T4),while the HR and MAP in the study group at the end of operation( T5) were significantly lower than those in the control group( P < 0. 05). The Visual Analogue Scale( VAS)scores in the two groups increased first and then decreased at 1 h( T6),6 h( T7) and 12 h( T8) after operation,and those in the study group were lower than those in the control group( P < 0. 05). The Ramsay sedation score in the study group was significantly higher than that in the control group( P < 0. 05). Compared with those in the operation room( T1),the levels of cortisol( Cor),blood sugar( Glu)and norepinephrine( NE) at T4 and T5 in the two groups were significantly increased,and those in the study group were significantly lower than those in the control group( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). Conclusion Dexmedetomidine combined with ketorolac tromethamine for pre-adjuvant anesthesia in patients underwent LC has good anesthetic effect,which can maintain hemodynamics,alleviate the body’s stress response without increasing the adverse reactions.
作者
戴洁群
周国霞
王芳
姚毅真
DAI Jiequn;ZHOU Guoxia;WANG Fang;YAO Yizhen(Department of Anesthesiology,The Fifth People's Hospital of Shanghai,Shanghai,China 200240)
出处
《中国药业》
CAS
2019年第12期63-66,共4页
China Pharmaceuticals
基金
上海市科学技术委员会科研计划项目[16401970104]
