右美托咪定与依托咪酯在老年颅脑手术麻醉中的应用价值

Study on the application value of dexmedetomidine and etomidate in anesthesia for senile craniocerebral surgery

目的:探讨并分析对接受手术治疗的老年颅脑损伤患者进行麻醉时为其应用右美托咪定与依托咪酯的效果。方法:将2018年1月至12月期间在钦州市第二人民医院进行手术治疗的108例老年颅脑损伤患者随机分为观察组(OBG组,n=54)与对照组(REG组,n=54)。术中,对两组患者均进行静吸复合麻醉。在进行麻醉诱导及麻醉维持时,为OBG组患者静脉注射右美托咪定与依托咪酯,为REG组患者进行静脉注射依托咪酯,然后比较两组患者在麻醉诱导前(T0)、麻醉诱导后(T1)、气管插管前(T2)、气管插管后即刻(T3)、气管插管后10 min(T4)及气管插管后30 min(T5)的心率(HR)、血氧饱和度(SpO2)、平均动脉压(MAP)及术中其麻醉相关不良事件的发生率。结果:在T3、T4和T5,OBG组患者的MAP和HR均低于REG组患者,P<0.05。在T0、T1、T2、T3、T4和T5,两组患者的SpO2相比,P>0.05。OBG组患者术中麻醉相关不良事件的发生率低于REG组患者,P<0.05。结论:对接受手术治疗的老年颅脑损伤患者进行麻醉时为其应用右美托咪定与依托咪酯能保持其术中MAP和HR的稳定,降低其术中躁动、肌肉痉挛、寒战等不良事件的发生率。

Objective:To investigate and analyze the effects of dexmedetomidine and etomidate in anesthesia for elderly patients with craniocerebral injury undergoing surgical treatment.Methods:108 elderly patients with craniocerebral injury who were operated on in The Second People’s Hospital of Qinzhou City from January to December 2018 were randomly divided into observation group(OBG group,n=54)and control group(REG group,n=54).Intraoperatively,both groups of patients were subjected to combined aspiration anesthesia.During anesthesia induction and anesthesia maintenance for OBG group of patients with intravenous right beautiful mi and etomidate,etomidate intravenous injection for REG group of patients,then compared two groups of patients before anesthesia induction(T0),before anesthesia(T1)after induction,endotracheal intubation(T2),immediately after endotracheal intubation(T3),10 min after endotracheal intubation(T4)and 30 min after endotracheal intubation(T5)of heart rate(HR),blood oxygen saturation(SpO2),mean arterial pressure(MAP)and the incidence rate of intraoperative narcotic related adverse events.Results:In T3,T4 and T5,MAP and HR in OBG group were lower than those in REG group(P<0.05).In T0,T1,T2,T3,T4 and T5,SpO2 of patients in the two groups was compared to P>0.05.The incidence of anaesthesia related adverse events in OBG group was lower than that in REG group(P<0.05).Conclusion:Dexmedetomidine and etomidate can maintain the stability of MAP and HR and reduce the incidence of adverse events such as agitation,muscle spasm and chasm in elderly patients with craniocervical injury who receive surgical treatment during anesthesia.