右美托咪啶对老年卵巢癌患者脑氧饱和度和术后苏醒期的影响

Effects of dexmedetomidine on cerebral oxygen saturation and postoperative revival period in elderly patients with ovarian cancer

目的观察右美托咪啶对老年卵巢癌患者脑氧饱和度和术后苏醒期的影响。方法2016年7—12月择期浙江省肿瘤医院行老年卵巢癌手术患者60例，随机分为2组，右美托咪啶组（D组），对照组（C组）。两组均选择全凭静脉麻醉，D组患者气管插管之后给予泵注右美托咪啶负荷量0．5μg/kg，10min泵完，以0．2μg·kg^-1·h^-1静脉维持，术毕前30min停止用药；C组给予生理盐水泵注，速度与方法同D组，观察并记录麻醉前（T0）、手术开始1h（T1）、术毕（T2）、气管拔管后30min（T3）时的脑氧饱和度。同时观察两组患者拔管时间、以及恢复期躁动、寒战、呼吸抑制等不良反应。结果运用SPSS20．0软件统计分析得知，两组患者组间在各时间点脑氧饱和度麻醉前[（70．1±2．5）％与（70．7±3．2）％]与手术开始1h[（64．9±2．1）％与（63．8±2．9）％]、术毕[（68．3±3．1）％与（69．3±3．3）％]、拔管后30min[（69．8±3．0）％与（70．0±2．8）％]比较差异无统计学意义（P〉0．05）；跟C组相比（10例），D组（4例）的躁动程度及其发生率降低，且寒战（9例与5例）等不良反应低，差异有统计学意义（P〈0．05）。结论右美托咪啶对老年卵巢癌手术患者脑氧饱和度未见明显影响，可有效预防和减少术后恢复期躁动，不影响苏醒时间，不良反应少。

Objective To observe the effects of dexmedetomidine on cerebral oxygen saturation and postoperative recovery in elderly patients with ovarian cancer. Methods Sixty elderly patients with ovarian cancer were randomly divided into two groups. Both groups were given total intravenous anesthesia. Patients in group D were given a loading dosage of dexmedetomidine 0. 5μg/kg, followed by continuous infusion 0. 2μg·kg^-1·h^-1 until 30 minutes before the end of operation. Group C were given normal saline at the same time. The cerebral oxygen saturation was observed and recorded before anaesthesia （TO） , an hour after operation （T1）, the end of operation （T2） and 30 min after tracheal extubation （T3）. The time of extubation and adverse reactions such as restlessness, shivering and respiratory inhibition were observed in both groups. Results There was no significant difference in cerebral oxygen saturation between the two groups at different time points （ P 〉 0. 05 ）, and the degree of restlessness and its incidence in group D were lower than those in group C, and the adverse reactions such as shivering were lower （P 〈 0.05 ）. Conclusion Dexmedetomidine has no obvious effect on cerebral oxygen saturation in elderly patients with ovarian cancer. It can effectively prevent and reduce postoperative restlessness, does not affect recovery time, and has fewer adverse reactions.