摘要
目的分析不同剂量右美托咪定对全麻高血压手术患者的镇痛效果及安全性。方法选取2018年6月至2020年6月于我院接受全麻手术的66例高血压患者作为研究对象,按照随机数字表法将其分为对照组和观察组,每组33例。两组均在麻醉诱导前给予右美托咪定静脉泵注,对照组剂量为0.6μg/kg,观察组剂量为0.4μg/kg。比较两组的镇痛效果、不同时间的血流动力学指标、认知状况及呛咳反应程度。结果两组的SAS、VAS评分及BIS值比较,差异无统计学意义(P>0.05);观察组的定向力恢复时间、唤醒睁眼时间均短于对照组,差异具有统计学意义(P<0.05)。诱导前,两组的MAP、RPP、PRQ比较,差异无统计学意义(P>0.05);诱导后、拔管时、拔管后5 min,两组的MAP、RPP、PRQ均较诱导前有所波动;诱导后、拔管时、拔管后5 min,观察组的MAP、RPP、PRQ均优于对照组,差异具有统计学意义(P<0.05)。术前,两组的MMSE评分比较,差异无统计学意义(P>0.05);术后12、24 h,观察组的MMSE评分均高于对照组,差异具有统计学意义(P<0.05)。观察组的呛咳反应程度轻于对照组,差异具有统计学意义(P<0.05)。结论全麻高血压手术患者在麻醉诱导前给予0.4μg/kg的右美托咪定静脉泵注具有更好的镇痛效果,可维持血流动力学稳定,减轻呛咳反应程度,利于患者术后苏醒及认知功能恢复,值得临床选用。
Objective To analyze the analgesic effect and safety of different doses of dexmedetomidine in hypertension patients undergoing general anesthesia.Methods A total of 66 hypertension patients who underwent general anesthesia in our hospital from June 2018 to June 2020 were selected as the study objects,and the patients were divided into control group and observation group according to the random number table method,with 33 cases in each group.Both groups were given dexmedetomidine intravenous pump before anesthesia induction,the dose of the control group was 0.6μg/kg,and the dose of the observation group was 0.4μg/kg.The analgesic effect,hemodynamic indexes at different times,cognitive status and the degree of choking reaction were compared between the two groups.Results There were no significant differences in SAS,VAS scores and BIS value between the two groups(P>0.05);the recovery time of directional force and the time of waking up and opening eyes in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Before induction,there were no significant differences in MAP,RPP and PRQ between the two groups(P>0.05);after induction,during extubation and 5 min after extubation,MAP,RPP and PRQ of the two groups fluctuated compared with those before induction;after induction,during extubation and 5 min after extubation,MAP,RPP and PRQ in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).Before operation,there was no significant difference in MMSE score between the two groups(P>0.05);at 12 and 24 h after operation,the MMSE score in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The degree of choking reaction in the observation group was lighter than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The 0.4μg/kg dexmedetomidine intravenous pump was given hypertension patients undergoing general anesthesia before anesthesia induction has a better analgesic effect,it can maintain the hemodynamic stability,reduce the degree of choking reaction,and is conducive to postoperative recovery and cognitive function recovery of patients,which is worthy of clinical selection.
作者
曹婷
霍建臻
王文文
CAO Ting;HUO Jianzhen;WANG Wenwen(Yulin No.2 Hospital,Yulin 719000,China)
出处
《临床医学研究与实践》
2022年第7期108-111,共4页
Clinical Research and Practice
关键词
右美托咪定
高血压
全麻
血流动力学
认知功能
dexmedetomidine
hypertension
general anesthesia
hemodynamic
cognitive function
