右美托咪定辅助椎管内麻醉在快速康复外科应用的效果评价

Effect Evaluation of Dexmedetomidine in Assistance of Intrathecal Anesthesia in Application in Rapid Rehabilitation Surgery Department

目的探讨右美托咪定辅助椎管内麻醉在快速康复外科应用的效果。方法选择2016年4月—7月择期在腰硬联合麻醉下手术患者40例进行回顾性分析。根据麻醉药物不同分为观察组和对照组,每组20例。麻醉穿刺成功后,观察组静脉泵注右美托咪定,对照组术中辅助适量芬太尼和咪达唑仑。测定两组麻醉前(T0)、右美托咪定泵注60 min(T1)时血浆肾上腺素(E)和去甲肾上腺素(NE)浓度、压力痛阈值、平均动脉压(MAP)以及心率,同时记录整个手术过程中的不良反应情况和术后满意度评分。结果 T1时,观察组MAP、心率、血浆E和NE浓度明显低于对照组(P<0.05),压力痛阈值明显高于对照组(P<0.05)。观察组术后患者满意度评分高于对照组(P<0.05),不良反应发生率低于对照组(P<0.05)。结论右美托咪定辅助椎管内麻醉可以降低手术应激反应,减少不良反应的发生率,提高患者的压力痛阈值和满意度,有利于患者快速康复。

Objective To investigate effect of Dexmedetomidine in assistance of intrathecal anesthesia in application of rapid rehabilitation surgery department.Methods Clinical data of40patients with selective surgery under combined spinal epidural anesthesia from April to July2016was retrospectively analyzed,and the patients were divided into observation group and control group(n=20for each group)according to differently anesthetic drugs.After the successful puncture,observation group was treated with Dexmedetomidine by venous pump,while control group was treated with appropriate dose of Fentanyl and Midazolam during surgery.In two groups,values of plasma epinephrine(E)and norepinephrine(NE)concentrations,pressure pain threshold value,mean arterial pressure(MAP)and heart rate were detected before anesthesia(T0)and at60min after Dexmedetomidine by venous pump(T1),and adverse reactions and postoperative satisfaction scores during surgery were simultaneously recorded.Results At T1in observation group,values of MAP,heart rate,plasma E and NE concentrations were significantly lower(P<0.05),while pressure pain threshold value was significantly higher than those in control group(P<0.05).In observation group,postoperative satisfaction score was significantly higher(P<0.05),while incidence rate of adverse reactions was significantly lower than those in control group(P<0.05).Conclusion Dexmedetomidine in assistance of intrathecal anesthesia may reduce stress reaction and adverse reactions,improve patient's pain threshold value and satisfaction degree,and it may help patients'rapid recovery.