右美托咪定复合瑞芬太尼在择期全麻脊柱手术控制性降压中的应用

Dexmedetomidine combined with remifentanil anesthesia in elective spinal surgery to control hypotension

目的探讨右美托咪定复合瑞芬太尼在择期全麻脊柱手术控制性降压中的应用效果。方法将60例择期全麻脊柱手术患者随机分为两组,各30例。对照组采用瑞芬太尼麻醉,观察组采用右美托咪定复合瑞芬太尼麻醉,比较两组术中体征指标。结果两组患者在T_1、T_2、T_3、T_4时平均动脉压、心率均有一定变化,观察组组内比较,差异无统计学意义(P>0.05),对照组组内比较,差异具有统计学意义(P<0.05);两组患者T_1、T_2、T_3、T_4同期平均动脉压、心率比较,观察组平均动脉压高于对照组(P<0.01),心率低于对照组(P<0.01);观察组苏醒质量高于对照组(P<0.01),头痛发生率低于对照组(P<0.05)。结论右美托咪定复合瑞芬太尼在择期全麻脊柱手术中的应用,可有效起到控制性降压的效果,且对于降低术后不良反应的发生具有重要临床价值。

Objective To investigate the effects of dexmedetomidine combined with remifentanil anesthesia to control hypotension in elective spinal surgery. Methods Sixty patients undergoing elective spinal surgery were randomly divided into two groups,each with a total of 30 cases. The control group was treated with remifentanil anesthesia,observation group were treated with dexmedetomidine and remifentanil anesthesia,clinical signs of two groups were compared. Results The changes of mean arterial pressure,heart rate in T1,T2,T3,T4,the difference was not statistically significant（ P〉0. 05） in observation group,the control group,the difference was statistically significant（ P〈0. 05）. Comparison of average arterial pressure and heart rate in two patients of group in T1,T2,T3,T4,The mean arterial blood pressure in observation group was higher than the control group（ P〈0. 01）,heart rate（ P〈0. 01） lower than that of the control group. Recovery quality of observation group is higher than that of control group（ P〈0. 01）,the incidence of headache was lower than that of control group（ P〈0. 05）. Conclusion The application of dexmedetomidine and remifentanil in general anesthesia during spinal surgery,can effectively play the effect of controlled hypotension,and has an important clinical value for reducing postoperative adverse reaction.