不同剂量右美托咪定对老年糖尿病足截趾患者全身麻醉苏醒期的影响

Influence of Dexmedetomidine of Different Doses in the Recovery Period of General Anesthesia in the Toe Amputation of Elderly Patients with Diabetic Foot

目的对比分析不同剂量右美托咪定对老年糖尿病足截趾患者全身麻醉苏醒期的影响。方法选取2017年4月至2018年8月北京市丰台区南苑医院收治的102例拟行截趾术治疗的老年糖尿病足患者作为研究对象,并按照随机数表法将其随机分为低剂量组(51例)和高剂量组(51例),其中低剂量组患者于全身麻醉时静脉缓慢泵注0.4μg/kg的盐酸右美托咪定注射液,高剂量组患者于全身麻醉时静脉缓慢泵注0.8μg/kg的盐酸右美托咪定注射液,对比观察两组患者诱导麻醉前、拔管时、拔管后5 min、拔管后10 min的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2),以及苏醒时间及拔管时间。结果诱导麻醉前、拔管时、拔管后5 min、拔管后10 min,两组患者MAP、HR及SpO2对比,P均>0.05,差异无统计学意义;低剂量组患者的苏醒时间为(14.02±5.87)min、拔管时间为(16.55±5.26)min,明显低于高剂量组患者的苏醒时间(18.16±6.29)min、拔管时间(22.73±6.84)min,两组对比,P均<0.05,差异具有统计学意义。结论老年糖尿病足患者在截趾术中应用低剂量右美托咪定辅助麻醉,可有效缩短患者苏醒时间及拔管时间,维持患者苏醒期的血流动力学稳定性,安全性较高,具有临床推广价值。

Objective To analyze and compare the influence of Dexmedetomidine of different doses in the recovery period of general anesthesia in the toe amputation of elderly patients with diabetic foot.Methods One hundred and two elderly patients with diabetic foot with the intention of receiving toe amputation in Nanyuan Hospital between April 2017 and August 2018 were selected as study subjects to be divided into a low dose group(51 patients)and a high dose group(51 patients)according to the random number table.In the low dose group,0.4μg/kg Dexmedetomidine Hydrochloride Injection was infused intravenously and slowly for general anesthesia,while in the high dose group,0.8μg/kg Dexmedetomidine Hydrochloride Injection was infused intravenously and slowly for general anesthesia.The mean arterial pressure(MAP),heart rate(HR)and oxygen saturation(Sp02)at the time points of before the induced anesthesia,during the extubation,5 min after the extubation and 10 min after the extubation,and the awaking time and extubation time were observed and compared between the two groups.Results MAP,HR and SpO2 were respectively compared between the two groups at the time points of before the induced anesthesia,during the extubation,5 min after the extubation and 10 min after the extubation,and the results showed no statistically significant difference(all P>0.05).The awaking time was(14.02±5.87)min and extubation time was(16.55±5.26)min in the low dose group,which showed statistically significant differences as compared with the corresponding(18.16±6.29)min and(22.73±6.84)min in the high dose group,P<0.05.Conclusion In the toe amputation of elderly patients with diabetic foot,the auxiliary application of low dose of Dexmedetomidine can effectively shorten the awaking time and extubation time of patients and maintain the hemodynamic stability in the recovery period,presenting high safety and clinical application value.