依托咪酯靶控输注联合右美托咪定对胃癌根治术患者血流动力学术后疼痛及感染状况的影响

Effects of etomidate target-controlled infusion combined with dexmedetomidine on hemodynamics,postoperative pain and infection status in patients with radical gastric cancer surgery

目的探讨依托咪酯靶控输注联合右美托咪定对胃癌根治术患者血流动力学、术后疼痛及感染状况的影响.方法将82例拟行胃癌根治术的患者按麻醉方法分为两组,每组41例.两组在诱导麻醉中均采用靶控输注依托咪酯麻醉,观察组在此基础上联合静脉注射右美托咪定麻醉.于入室时、用药时及拔管时记录心率、血压,统计麻醉效果、术后患者疼痛及感染状况.结果(1)血流动力学:入室时两组患者心率、收缩压及舒张压比较差异无统计学意义(P>0.05);用药时及拔管时观察组患者心率显著高于对照组(P<0.01),两组患者收缩压、舒张压比较差异无统计学意义(P>0.05).(2)麻醉效果:两组恢复自主呼吸时间、拔除气管导管时间比较差异无统计学意义(P>0.05).(3)术后疼痛及感染状况:观察组视觉模拟评分法评分、疼痛率、感染程度评分及感染率均显著显著低于对照组(P<0.05或0.01).结论依托咪酯靶控输注联合右美托咪定对胃癌根治术患者麻醉效果显著,有助于维持患者血流动力学稳定,减轻术后疼痛,降低术后感染发生率.

Objective To investigate the effect of etomidate target-controlled infusion combined with dexmedetomidine on hemodynamics,postoperative pain and infection status in patients with radical gastric cancer surgery.Methods 82 patients underwent radical gastrectomy were divided into two groups,41 cases each.In both groups,target-controlled infusion of etomidate anesthesia was used for induction anesthesia,and the observation group was combined with intravenous dexmedetomidine anesthesia on this basis.Heart rate and blood pressure were recorded at the time of admission,medication and extubation,and the effects of anesthesia,postoperative pain and infection were recorded.Results(1)Hemodynamics:There was no significant difference in heart rate,SBP,and DBP between the two groups at the time of admission(P>0.05).The heart rate of the observation group was significantly higher than that of the control group at the time of medication and extubation(P<0.01).There was no significant difference in SBP and DBP between the two groups(P>0.05).(2)Anesthesia effect:There was no significant difference in recovery of spontaneous breathing time and tracheal tube removal time between the two groups(P>0.05).(3)Postoperative pain and infection status:The visual analogue score,pain rate,infection degree score,and infection rate in the observation group were significantly lower than those in the control group(P<0.05 or 0.01).Conclusions Etomidate target-controlled infusion combined with dexmedetomidine has a significant therapeutic effect on patients undergoing radical gastrectomy.It helps maintain hemodynamic stability in patients,reduces postoperative pain,and reduces the incidence of postoperative in-fections.