右美托咪定对结直肠癌根治术患者血流动力学及麻醉恢复质量的影响

Effect of dexmedetomidine on anesthesia recovery in patients undergoing radical resection of colorectal

目的观察右美托咪定对七氟醚吸入全身麻醉术后恢复质量的影响。方法选取2014年8月至2017年2月本院收治的94例结直肠癌患者为研究对象,随机分为观察组与对照组,每组各47例。两组均行腹腔镜结直肠癌根治术,观察组于全身麻醉插管后给予右美托咪定,对照组予以等量的0.9%氯化钠注射液。比较两组不同时刻,即诱导前(T_1)、手术前(T_2)、术后开始30 min(T_3)、手术开始1 h(T_4)、术毕(T_5)、拔管前(T_6)及拔管即刻(T_7)的心率(HR)、平均动脉压(MAP),以及麻醉复苏质量与麻醉恢复期躁动发生率。结果两组T_1~T_5时刻的HR与MAP差异均无统计学意义(均P>0.05);观察组T_6、T_7时刻的HR及MAP均低于对照组(均P<0.05)。术前,两组生理、情感及认知功能评分差异均无统计学意义(均P>0.05);术后30 min,观察组各项评分较术前均无显著改变(均P>0.05),对照组生理与认知和功能评分较术前降低、情感评分较术前升高(均P<0.05);术后30 min,两组生理、情感及认知功能评分差异均有统计学意义(均P<0.05)。麻醉恢复期,观察组的躁动发生率为19.15%(9/47),显著低于对照组的38.30%(18/47),差异有统计学意义(P<0.05)。结论腹腔镜结直肠癌根治术中,在全身麻醉插管后持续匀速静脉泵注右美托咪定有利于保持稳定血流动力学,提高患者麻醉复苏质量,降低苏醒期躁动发生率。

Objective To observe the effect of dexmedetomidine on the recovery of sevoflurane inhalation after general anesthesia.Methods 94 patients with colorectal cancer were selected and randomly divided into the observation group and control group with 47 cases in each group.according to the random number table, The patients in the two groups underwent laparoscopic radical resection of colorectal cancer, the observation group was treated with dexmedetomidine after general anesthesia and the control group was given0.9% sodium chloride injection. The HR, MAP, mental function and the incidence of restlessness during anesthesia recovery were compared between two groups, including the time before anesthesia induction（T1）, before operation（T2）, 30 min after opreation（T3）, 1 h after operation（T4）, the end of operation（T5）, before extubation（T6） and immediately after extubation（T7）. Results There were no significant difference between HR and MAP at T1-T5moment in two groups（P 〈 0.05）. The HR [（80.64±5.14）times/min,（83.13±5.50）times/min] and MAP [（97.88±5.33）mm Hg,（102.00±5.80）mm Hg] at T6 and T7moment in the observation group were lower than the control group [（87.34 ±5.66）times/min,（90.22 ±6.01）times/min], [（102.71 ±4.60） mm Hg,（107.84 ±6.31） mm Hg]（P 〈 0.05）. There were no obvious difference in the scores of physiology, emotion and cognitive function between the two groups（P 〈 0.05）. There were no evident changes in the scores of the observation group at 30 min after operation（P 〈 0.05）, while the scores of physiology, cognition and function were decreased and the scores of emotion were increased（P 〈 0.05）. The physiological and cognitive and functional scores in observation group [（25.27±1.62）points,（22.14±3.55）points] were significantly higher than the control group [（22.62±2.01）points and（18.96±3.42）points],and the emotional score [（2.82±0.74）points] was lower than the control group [（3.54±0.83）points]（P 〈 0.05）. The incidence of restlessness in the anesthesia group was 19.15%, which was lower than that in the control group（38.30%, P 〈 0.05）. Conclusion In the laparoscopic radical resection of colorectal cancer, continuous intravenous intravenous injec-tion of dexmedetomidine was more conducive to maintaining stable hemodynamics, avoid postoperative mental disorders, improve the quality of anesthesia recovery and reduce the recovery period of restlessness.