椎管内麻醉术中右美托咪定辅助用药对患者应激反应的影响

Effects of dexmedetomidine on stress response in intra-operative intraspinal anesthesia

目的探讨椎管内麻醉手术中右美托咪定对患者应激反应的影响。方法选择我院接受椎管内麻醉的患者60例,ASA分级Ⅰ或Ⅱ级,拟行下腹部或下肢手术。采取双盲法按随机数字表分为两组,每组30例。观察组实施椎管内麻醉后静脉应用右美托咪定,对照组实施椎管内麻醉后静脉应用咪达唑仑。记录两组各时点的听觉诱发电位指数(auditory evoked potential index,AEPI)、心率变化及恶心、呕吐和呼吸抑制情况,比较两组应激反应及不良反应。结果T0时,两组间AEPI差异无统计学意义(P>0.05),T1、T2、T3、T4时观察组AEPI较对照组下降(P<0.05);T0时,两组心率变化差异无统计学意义(P>0.05),T1、T2、T3、T4观察组心率指标更稳定,与对照组比较差异有统计学意义(P<0.05);观察组不良反应发生率低于对照组(6.67%vs 40.00%,P<0.05)。结论椎管内麻醉术中应用右美托咪定,其镇静效果好,可降低机体应激反应。

Objective To explore the effects of dexmetomidine on stress response of intra-operative spinal anesthesia.Methods Sixty patients receiving the spinal canal anesthesia in the Hospital during the period were selected,ASA physical status at GradeⅠor GradeⅡwas implemented,and lower abdomen or lower extremity surgery was proposed to be implemented.Double-blind method was applied to group patients into two groups with 30 cases in each group by based on the random number table method.The dexmedetomidine anesthesia was implemented for patients in the observation group,and the midazolam anesthesia was implemented for patients in the control group.These conditions are recorded about the auditory evoked potential index(AEPI),change in heart rate,vomiting,nausea,respiratory inhibition of two groups of patients.And It were Compared the two groups stress and adverse reactions.Results The difference in AEPI of patients in two groups wasn’t statistically significant at T0(P>0.05),while the AEPI of patients in the observation group declined when compared to such indices of patients in the control group at T1,T1,T3 and T4(P<0.05);the difference in change of heart rate of patients in two groups wasn’t statistically significant at T0(P>0.05),and the heart rate index of patients in the observation group was more stable at T1,T1,T3 and T4,and the difference was statistically significant when compared to such index of patients in the control group(P<0.05);the incidence of adverse reactions of patients in the observation group was lower than that of patients in the control group Group(6.67%vs 40.00%,P<0.05).Conclusion Dexmedetomidine used for sedation in intraspinal anesthesia delivers remarkable effect and can reduce the body stress response of patients.