右美托咪定联合舒芬太尼对心脏手术患者麻醉苏醒期心血管应激及躁动的影响

The effect of dexmedetomidine combined with sufentanil on cardiovascular stress and agitation in cardiac surgery

目的观察右美托咪定联合舒芬太尼对心脏手术患者麻醉苏醒期心血管应激及躁动的影响。方法选择2014年1月至2015年1月该院收治的40例心脏手术患者为研究对象,分为对照组和试验组。对照组患者接受舒芬太尼进行麻醉,试验组患者接受舒芬太尼联合右美托咪定进行麻醉。观察与评估两组患者麻醉苏醒期4个时间点[手术结束前10min(T0)、气管拔管前(T1)、气管拔管后即刻(T2)、拔管后5min(T3)]的血流动力学指标变化与躁动情况,其中血流动力学指标有收缩压、心率与脉搏血氧饱和度。结果 T0时两组患者的心率和收缩压差异均无统计学意义(P>0.05),但T1、T2、T3时对照组患者的心率和收缩压都较T0时显著升高,且均明显高于同时间点试验组患者(P<0.05)。两组患者在T0、T1、T2、T3时间点的脉搏血氧饱和度差异无统计学意义(P>0.05)。试验组患者躁动分级显著低于对照组患者(P<0.05)。结论对心脏手术患者麻醉,采用右美托咪定联合舒芬太尼药物,可很好控制全身麻醉苏醒期的心血管反应,使拔管过程更加平稳,且有效避免了患者苏醒期躁动,值得进行临床推广。

Objective To investigate the effects of dexmedetomidine combined with sufentanil for patients with cardiac surgery anesthesia and cardiovascular stress.Methods The effects of 40 cases of restless heart surgery patients in our hospital during January 2014 to January 2015 were included as an example,in accordance with the principle of randomization,it can be divided into control group and experimental group.The control group received sufentanil anesthesia,the experimental group patients received sufentanil combined with dexmedetomidine anesthesia.Observe and evaluate the changes in hemodynamics of two groups of patients during the recovery period of 4 time points and restlessness,the hemodynamic indexes have systolic blood pressure(SBP),heart rate(HR)and pulse oxygen saturation(SpO 2).Results Before the end of surgery(T0)there were no significant differences in heart rate and systolic blood pressure in two groups(P>0.05)but before tracheal extubation(T1),tracheal immediately after the tube(T2),5 min after extubation(T3)control of heart rate and systolic pressure groups are lower than those before the end of surgery(T0)were significantly increased,and significantly.At the same time higher than that of patients in the experimental group(P<0.05).There were no significant differences in pulse oxygen saturation at four time points in two groups(P>0.05).The experimental group patients with restlessness is lower than that of control group(P<0.05).Conclusion This study shows that anesthesia for cardiac surgery patients with dexmedetomidine.The drug can be combined with sufentanil,control of cardiovascular responses during anesthesia recovery period,the extubation process more smoothly and effectively avoid the restlessness of patients in recovery period,it is worthy of clinical promotion.