右美托咪定对结肠癌患者血流动力学及苏醒期躁动的影响

Effect of Dexmedetomidine on Hemodynamics and Awakening Priod Restlessness in Patients with Colon Cancer

目的探讨右美托咪定与丙泊酚持续输注对结肠癌患者血流动力学及术后镇静—躁动评分影响。方法 80例择期结肠癌手术患者随机分为右美托咪定组(DS组)和丙泊酚组(PS组)。DS组诱导前10 min泵注右美托咪定1μg/kg,术中以0.5μg/(kg·h)速度持续输注,PS组诱导前10 min泵注等量生理盐水,术中持续泵注丙泊酚4 mg/(kg·h),术中两组患者均吸入七氟烷,维持脑电双频指数(BIS)为45~55。记录两组患者入室后(T0)、诱导前(T1)、诱导后(T2)、插管后即刻(T3)、插管后3 min(T4)、手术开始(T5)、拔管时(T6)血压及心率变化,记录手术时间、苏醒时间及术后镇静—躁动评分。结果两组手术时间及术后苏醒时间差异无统计学意义(P>0.05);与T0相比,PS组血压、心率T1到T5各时点先明显下降后明显升高(P<0.05),DS组变化不明显;与PS组相比,DS组各时间点组间比较差异有统计学意义(P<0.05)。镇静—躁动评分DS组显著低于PS组(P<0.05)。结论结肠癌患者术中持续输注右美托咪定,有利于维持患者血流动力学稳定,预防术后躁动发生,提高患者苏醒质量。

Objective To investigate the effect of continuous infusion of dexmedetomidine and propofol on hemodynamics and postoperative sedation-agitation score in patients with colon cancer. Methods 80 patients underwent elective colon cancer surgery were randomly divided into dexmedetomidine group（ DS group） and propofol group（ PS group）. In the DS group,dexmedetomidine（ 1μg/kg） was pumped 10 minutes before induction and was continuously infused at 0. 5 μg/（ kg·h） during the operation. The PS group received an equal volume of saline 10 minutes prior to induction,and propofol was continuously pumped at 4 mg/（ kg·h） during the operation. Both groups inhaled sevoflurane during operation and maintained a bispectral index（ BIS） of 45 ~ 55. Blood pressure and heart rate changes after admission（ T0）,before induction（ T1）,after induction（ T2）,immediately after intubation（ T3）,3 minutes after intubation（ T4）,at the time of starting operation（ T5） and extubation（ T6） were recorded. Moreover,operation time,wake-up time and postoperative sedation-agitation score of both groups were recorded. Results There was no statistical difference between the two groups in the operation time and wake-up time（ P〈0. 05）,compared with T0,blood pressure and heart rate from T1 to T5 in the PS group decreased significantly first and then increased obviously at each time point（ P〈0. 05）,while those in the DS group did not change significantly,compared with the PS group,there was statistically significant difference between groups at each time point in the DS group（ P〈0. 05）,the sedation-agitation score of the DS group was significantly lower than that of the PS group（ P〈0. 05）. Conclusion Continuous infusion of dexmedetomidine for patients with colon cancer during the operation is beneficial to maintaining hemodynamic stability and preventing postoperative restlessness,which can improve patients＇ recovery quality.