不同剂量右美托咪定对腹腔镜下结直肠癌手术苏醒期躁动及早期认知功能影响的研究

Effects of different doses of dexmedetomidine on awakening agitation and early cognitive dysfunction in patients after laparoscopic surgery for colorectal cancer

目的分析不同剂量右美托咪定对腹腔镜下结直肠癌手术苏醒期躁动及早期认知功能的影响。方法选择在该院接受腹腔镜手术治疗的148例结直肠癌患者作为研究对象,在麻醉过程中随机分为对照组(A组)、小剂量组(B组)、中剂量组(C组)和大剂量组(D组),B、C、D组诱导时给予右美托咪定负荷剂量0.5μg/kg,术中分别泵注0.2、0.5及0.8μg/(kg·h),手术结束前30 min停止,A组以相同方式给予等容量生理盐水。比较各组患者躁动与镇静评分、炎症因子水平、苏醒时间及认知功能评分差异。结果 C、D组与A、B组比较躁动评分降低、炎症因子水平优化且术后认知功能提高(P<0.05);D组与A、B、C组比较患者的镇静评分升高且苏醒延迟(P<0.05)。结论中剂量右美托咪定术中应用可以显著减少麻醉苏醒期躁动,优化患者炎症因子水平、减少患者术后认知功能损伤。

[ Objective ] To analyze effects of different doses of dexmedetomidine on awakening agitation and early cognitive dysfunction in patients after laparoscopic surgery for colorectal cancer. [Methods] 148 cases of pa- tients with colorectal cancer laparoscopic surgery were randomly divided into control group （group A） and small dose group （group B）, middle dose group （group C）, high-dose group （group D）. The induced B, C, D group were given loading dose 0.5p.g/kg of dexmedetomidine, intravenous 0.2, 0.5, 0.8μg/kg per hour by pump, stopped pumping 30 min before the end of surgery. The group A was given the same volume of physiological saline in the same way. The restless and sedation scores, inflammatory factor levels, difference in cognitive function score and awakening time in different groups were compared. [ Results ] The agitation scores were lower, postoperative inflammatory levels were better, cognitive function was improved in group C and D compared with group A and B （P 〈0.05）. The sedation scores of patients in group D were raised compared with other groups, and awakening delayed （P 〈0.05）. [ Conclu- sion] Middle dose dexmedetomidine can significantly reduce anesthetic revival period agitation, optimize patients with inflammatory factor levels, and decrease injury of postoperative cognitive function.