右美托咪定在食管癌麻醉中的应用价值分析

Application of dexmedetomidine in anesthesia for esophageal cancer surgery

目的观察右美托咪定在食管癌手术麻醉中的应用效果及临床意义.方法采用随机数字表法将80例食管癌患者分为对照组和观察组,每组40例.对照组患者接受静脉麻醉,观察组患者在此基础上给予右美托咪定.观察两组患者麻醉前和手术开始后1 h的血流动力学指标[收缩压(SBP)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2)]和应激指标[皮质醇、肿瘤坏死因子-α(TNF-α)],观察两组患者手术结束后1、4 h的镇静指标[脑电双频指数(BIS)、视觉模拟评分(VAS)].记录两组患者术后的不良反应发生情况.结果手术开始后1 h,观察组患者的MAP、SBP水平均明显高于对照组患者(P﹤0.01).手术结束后1、4 h,观察组患者的VAS评分均明显低于对照组患者(P﹤0.01),但两组患者的BIS比较,差异均无统计学意义(P﹥0.05).手术开始后1 h,观察组患者的皮质醇、TNF-α水平均明显低于对照组患者(P﹤0.01).对照组与观察组患者的不良反应的发生情况比较,差异无统计学意义(P﹥0.05).结论右美托咪定对患者的循环系统、呼吸系统的影响轻微,在食管癌手术中的应用效果较好,具有良好的临床应用价值.

Objective To observe the effect and clinical significance of dexmedetomidine in anesthesia for esophageal cancer surgery. Method Eighty patients with esophageal cancer were included and randomly divided into control group and study group, with 40 cases in each. Patients in the control group received intravenous anesthesia, and patients in the study group were given dexmedetomidine additionally. Hemodynamic parameters [systolic blood pressure (SBP), mean arterial pressure (MAP), pulse oxygen saturation (SpO2)] and stress indicators [cortisol, tumor necrosis factor-α(TNF-α)] were observed before anesthesia and 1 h after starting surgery, sedation indexes [bispeetral index (BIS), visual analogue scale (VAS)] were assessed at 1 h and 4 h after surgery, respectively. The incidence of adverse reactions after surgery was recorded. Result In 1 hour after the start of surgery, the MAP and SBP levels in study group were significantly higher than those of the control group (P<0.01). In 1 h and 4 h after surgery, the VAS scores of study group were significantly lower than those of the control group, and the difference was statistically significant (P<0.01). However, there was no statistical difference regarding the BIS between the two groups (P>0.05). At 1 h after the start of surgery, the levels of cortisol and TNF-α in study group were significantly lower compared to control group (P<0.01). No evident differences were noted in regard to the incidence of adverse reactions between the control group and the study group (P> 0.05). Conclusion Dexmedetomidine demonstrates good analgesic effect in esophageal cancer surgery and is clinically applicable.