瑞芬太尼复合右美托咪定在心脏手术中的麻醉效果及对血流动力学的影响

Anesthetic Effect of Remifentanil combined with Dexmedetomidine in Cardiac Surgery and its Influence on Hemodynamics

目的:分析瑞芬太尼(REM)复合右美托咪定(DEX)在心脏手术中的麻醉效果及对患者血流动力学的影响。方法:选取我院2013年12月至2015年9月行心脏手术的100例患者,按随机数字表法分为两组麻醉Ⅰ组和麻醉Ⅱ组各50例。麻醉Ⅱ组患者以REM复合DEX进行麻醉;麻醉Ⅰ组患者以REM行麻醉。比较不同麻醉方式的麻醉效果及对血流动力学的影响。结果:麻醉Ⅱ组患者手术不同时间点动脉压、心率、血氧饱和度变化不明显,(P>0.05)。麻醉Ⅰ组患者插管即刻动脉压、心率、血氧饱和度下降显著,经t检验对比后有统计学意义(P<0.05)。麻醉Ⅱ组Ramsay评分明显高于麻醉Ⅰ组,经t检验对比后有统计学意义(P<0.05)。两组患者拔管、苏醒、恢复呼吸时间相近,无显著差异(P>0.05)。麻醉Ⅱ组麻醉优良率明显高于麻醉Ⅰ组,经x^2检验对比后有统计学意义(P<0.05)。结论:REM复合DEX在心脏手术中的麻醉效果确切,可维持患者血流动力学的平稳,提高镇静效果。同时不影响其拔管、苏醒和呼吸恢复,值得推广。

Objective： To investigate the anesthetic effect of remifentanil（REM） combined with dexmedetomidine（DEX） in cardiac surgery and its influence on hemodynamics. Methods： 100 patients underwent cardiac surgery in our hospital from December 2013 to September 2015, who were divided into anesthetic group Ⅰ and anesthetic group Ⅱ by random number table method, with 50 cases in each group.Anesthetic group Ⅱ was treated with REM combined with DEX,while the anesthetic group Ⅰ was treated with REM.Compared the anesthetic effect of different anesthetic methods and the influence on hemodynamics. Results： The arterial pressure, heart rate and blood oxygen saturation were not changed significantly at different time points in anesthetic group Ⅱ, the t test showed that the difference was not statistically significant（P〉0.05）. Above indexes in anesthetic group Ⅰ at intubation immediately were significantly decreased, the t test showed that the difference was statistically significant（P〈0.05）. Ramsay score in anesthetic group Ⅱ was significantly higher than anesthetic group Ⅰ, the t test showed that the difference was statistically significant（P〈0.05）. The extubation, analepsia, recovery of breathing time in two groups were closed, the difference was not statistically significant（P〉0.05）. The superior rate of anesthesia in anesthetic group Ⅱ was significantly higher than anesthetic group Ⅰ, the X^2 test showed that the difference was statistically significant（P〈0.05）. Conclusion：The anesthetic effect of REM combined with DEX is obvious in cardiac surgery, which can maintain the stability of the hemodynamics,improve the sedative effect, at the same time, it does not affect the extubation, analepsia, recovery of breathing,it is worth promoting.