右美托咪定复合瑞芬太尼用于老年人腹腔镜结肠癌根治术的效果观察

Effect of dexmedetomidine complex with remifentanil in elderly patients with laparoscopic colon cancer resection

目的：观察右美托咪定复合瑞芬太尼用于老年人腹腔镜结肠癌根治术的效果。方法选取老年人腹腔镜结肠癌根治术80例，按随机数字表法将患者分为研究组和对照组，每组40例。两组均给予常规诱导，术中给予瑞芬太尼、七氟烷维持麻醉。研究组麻醉诱导前10 min 泵入右美托咪定0．8μg／kg，然后以0.2μg＆#183;kg －1＆#183;h －1持续泵入直至手术结束；对照组给予等量0．9％氯化钠注射液。比较两组入室时（T0）、给药5 min（T1）、插管后（T2）、手术切皮（T3）和拔管后（T4）心率（HR）和平均动脉压（MAP），比较两组镇静评分、苏醒时间以及躁动评分。结果研究组 T1、T2、T3和 T4时 HR 和 MAP 分别为（62．2±1．1）次／min、（67．3±3．2）次／min、（69．2±2．3）次／min、（70．2±2．5）次／min 和（68．3±0．5）mmHg、（70．1±0．9）mmHg、（71．5±0．9）mmHg、（68．2±1．9）mmHg，均显著低于对照组，两组差异均有统计学意义（t ＝9．289、10．293、8.928、9.039、9．278、10．789、9．322、8．399，均 P ＜0．05）；对照组 T1、T2、T3和 T4时 HR 和 MAP 均显著高于 T0（t ＝8.928、9．892、8．387、8．927、9．783、9．073、9．039、7．938，均 P ＜0．05）；研究组镇静评分（4．2±1．3）分，显著高于对照组的（1．2±0．2）分，躁动评分（1．2±0．7）分，显著低于对照组的（2．9±1．5）分，两组差异均有统计学意义（t ＝9．387、8．379，均 P ＜0．05）。结论右美托咪定复合瑞芬太尼用于老年人腹腔镜结肠癌根治术具有较好的麻醉效果，血流动力学较稳定。

Objective To study the effect of dexmedetomidine complex with remifentanil in elderly patients with laparoscopic colon cancer resection.Methods 80 cases of elderly patients with laparoscopic colon cancer resec-tion were selected and divided into the study group and the control group with 40 patients in each group according to the random number table method.Two groups were induced conventionally,and intraoperative anesthesia maintained by remifentanil and sevoflurane.The study group were pumped dexmedetomidine 0.8μg/kg 10min before induction, then the doses reduced to 0.2 μg＆#183;kg -1 ＆#183;h -1 for continuous pumping until to the end of surgery,while the control group was pumped the same dose 0.9% sodium chloride injection,then the heart rate（HR）and mean arterial pres-sure（MAP）of the two groups were compared when entered into surgery room（T0 ）,administered 5min（T1 ）,after intubation（T2 ）,surgical incision（T3 ）and after extubation（T4 ）,and the compose score,recovery time,and agitation score of two groups were compared.Results HR and MAP of the study group at T1 ,T2 ,T3 and T4 were （62.2 ± 1.1）times/min,（67.3 ±3.2）times/min,（69.2 ±2.3）times/min,（70.2 ±2.5）beats/min and（68.3 ±0.5）mmHg,（70.1 ±0.9）mmHg,（71.5 ±0.9）mmHg,（68.2 ±1.9）mmHg significantly lower than which of the control group （t =9.289,10.293,8.928,9.039,9.278,10.789,9.322,8.399,all P 〈0.05）,and HR and MAP of the control group at T1 ,T2 ,T3 and T4 were significantly higher than T0,the differences were statistically significant（t =8.928, 9.892,8.387,8.927,9,783,9,073,9.039,7.938,all P 〈0.05）;Compose score（4.2 ±1.3）points of the study group was significantly higher than （1.2 ±0.2）points of the control group,but the agitation score of the study group was（1.2 ±0.7）points,which was significantly lower than （2.9 ±1.5）points of the control group,the differences were statistically significant（t =9.38,8.379,all P 〈0.05）.Conclusion Dexmedetomidine complex with remifen-tanil has a anesthetic good effect in elderly patients with laparoscopic colon cancer resection,and which can maintain the more stable hemodynamics.