右美托咪定经鼻喷雾在老年开腹手术患者麻醉中的应用效果观察

Observation of application effect of dexmedetomidine transnasal spray in anesthesia of elderly patients receiving open surgery

目的：探讨右美托咪定经鼻喷雾术前应用对老年开腹手术患者的血流动力学及麻醉用药的影响。方法选取我院从2013年3～9月门诊收治的40例老年开腹手术患者做为研究对象。采用随机表法分为生理盐水对照组C组20例，右美托咪定组D组20例。D组患者采用经鼻喷雾给药方法麻醉诱导前45min给药，右美托咪定用量为1μg/kg。对比两组患者的围术期血流动力学变化情况及苏醒时间。结果 C组及D组的苏醒时间接近，差异无统计学意义，D组患者麻醉后血流动力学变化稳定性明显优于C组，差异具统计学意义（P＜0.05）。结论1μg/kg右美托咪定经鼻喷雾给药作为老年开腹手术患者术前用药，可以减少麻醉药物用量，不影响术后苏醒，有助于围术期血流动力学稳定，给药方便，值得临床推广应用。

Objective To investigate the influence of preoperative application of dexmedetomidine transnasal spray on hemodynamics and anesthetic medication of elderly patients receiving open surgery. Methods Forty elderly patients receiving open surgery in the outpatient department of our hospital from March to September 2013 were selected as the study subjects and divided into the normal saline control group C with 20 patients and the dexmedetomidine group D with 20 patients. Group D received transnasal spray administration 45 minutes before anesthesia induction and the dosage of dexmedetomidine was 1μg/kg. The perioperative hemodynamic changes and recovery time of the two groups were compared. Results Group C and group D were close in the recovery time, with no statistically significant difference;Group D was significantly better than group C in the post-anesthetic of hemodynamic stability, with statistically significant difference（P 〈 0.05）. Conclusion 1μg/kg dexmedetomidine transnasal spray administration,as the preoperative medication for elderly patients receiving open surgery,can reduce the dosage of anesthetic drugs,does not influence postoperative recovery,is conducive to perioperative hemodynamic stability,and is convenient, thereby worthy of clinical promotion and application.