右美托咪定联合氟比洛芬酯在体腔热灌注术中的麻醉疗效

Anesthesia effect of Dexmedetomidine and flurbiprofen axetil on abdominal hot perfusion

目的：观察右美托咪定联合氟比洛芬酯在腹腔热灌术中的麻醉疗效。方法：选择60例拟在静脉复合麻醉下行腹腔热灌注术的腹腔肿瘤患者，AsAⅡ-Ⅲ级，随机分为两组，每组30例。A组在术前12min缓慢静注氟比洛芬酯1．5mg／kg（用时约2min），接着用10min输注1μg／kg右美托咪定负荷剂量，再以0．5μg·kg-1·h-1的速度持续输入右美托咪定；B组在术前12min缓慢静注芬太尼1．5μg／kg（用时约2min），后用右美托咪定的负荷量和维持量均同于A组。记录患者术前12min（T0）、手术开始（T1）、术中10min（T2）、术中30min（T3）以及术中60min（T4）各时段平均动脉压（MAP）、心率（HR）、血氧饱和度（SPO2）以及镇静与镇痛评分。结果：A组T1-T4的MAP、HR与B组相比差异具有统计学意义（P〈0．05），A组T2-T4镇静Ramsay评分与B组相比具有统计学意义（P〈0．05）。结论：两种麻醉方法均可完成手术，但以右美托咪定复合氟比洛芬酯更为安全有效，值得在临床上推广。

Objective.. To observe anesthesia effect of Dexmedetomidine and flurbiprofen axetil on abdominal hot perfu- siGn. Methods.. A total of 60 cases with abdominal tumor at ASA Ⅱ-Ⅲ class who would have abdominal hot perfusion under ve nous combined anesthesia were selected, and were divided randomly into two groups by half. Patients in Group A were treated with venous injection of Dexmedetomidine 1.5 mg/kg 12 rain before surgery for about 2 min, then with injection of 1 μg/kg flurbiprofen axetil for 10 min, followed by flurbiprofen axetil at 0.5 pig. kg 1. h-1. Patients in Group B were treated with fentanyl 1.5 μg/kg 12 min before surgery for about 2 rain, then with injection of 1μg/kg flurbiprofen axetil for 10 min, followed by flurbiprofen axetil at 0.5 μg·kg-1· h-1. Mean arterial pressure （MAP）, heart rate （HR）, SPO2 , score of sedation and anal- gesia at 12 min（T0 ）, at the beginning of surgery（T1 ）, 10 rain during surgery（T2 ）, 30 min during surgery（T3 ）, 60 rain during surgery（T3 ） were recorded. Results： There were significant differences in MAP and HR at T1-T4, and Ramsay score at T2-T4 between two groups （P〈0.05）. Conclusions： Dexmedetomidine combined with flurbiprofen axetil is safe and effective. It is worthy clinical application.