右美托咪定联合羟考酮对老年胃肠手术患者全身麻醉苏醒期躁动及应激反应的影响

Effects of Dexmedetomidine Combined with Oxycodone Hydrochloride on Aggressive Restlessness and Stress Response During General Anesthesia in Elderly Patients Undergoing Gastrointestinal Surgery

目的:探讨右美托咪定联合羟考酮对老年胃肠手术患者全身麻醉苏醒期躁动及应激反应的影响。方法:选取2016年7月至2017年12月辽宁省喀左县中心医院收治的拟行老年胃肠手术患者78例,以随机数字表法分为对照组与观察组,每组39例。两组患者均给予常规麻醉处理,对照组患者在手术结束前10 min微量输液泵静脉注射盐酸羟考酮,观察组患者在手术结束前10 min微量输液泵静脉注射右美托咪定联合盐酸羟考酮。观察两组患者麻醉诱导前(T_0)、拔管即刻(T_1)、拔管后5 min(T_2)及拔管后10 min(T_3)的心率(HR)、平均动脉压(MAP),呛咳评分、躁动评分及苏醒期躁动发生情况。结果:T_1、T_2和T_3时,观察组患者的HR、MAP明显低于对照组,差异均有统计学意义(P<0.05);观察组患者呛咳评分、躁动评分及苏醒期躁动发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论:手术结束前10 min微量输液泵静脉注射右美托咪定联合盐酸羟考酮可减轻老年胃肠手术患者的拔管应激反应,减少苏醒期躁动,提高苏醒质量。

OBJECTIVE： To probe into the effects of dexmedetomidine combined with oxycodone hydrochloride on Aggressive restlessness and stress response during general anesthesia in elderly patients undergoing gastrointestinal surgery. METHODS： 78 elderly patients undergoing gastrointestinal surgery admitted into Central Hospital of Liaoning Kazuo from Jul. 2016 to Dec. 2017 were extracted to be divided into control group and observation group via the random number table,with 39 cases in each. Two group of patients were treated with routine anesthesia. The control group was given oxycodone hydrochloride 10 min before the end of surgery,while patients in observation group received dexmedetomidine combined with oxycodone hydrochloride 10 min before the end of surgery. The heart rate（ HR） and mean arterial pressure（ MAP） before induction of anesthesia（ T_0）,extubation（ T_1）,5 min after extubation（ T_2）,and 10 min after extubation（ T_3）,cough score,restlessness score and restlessness during recovery in two groups were observed. RESULTS： At T_1,T_2 and T_3,the HR and MAP of observation group were significantly lower than those of control group,with statistically significant difference（ P〈0. 05）. The cough score,restlessness score and incidence of restlessness during recovery of observation group were significantly lower than those of control group,with statistically significant difference（ P〈0. 05）. CONCLUSIONS： Injection of dexmedetomidine combined with oxycodone hydrochloride 10 min before the end of surgery can relieve the extubation stress response in elderly patients undergoing gastrointestinal surgery,reduce restlessness during recovery and improve the quality of recovery from anesthesia.