地佐辛联合小剂量右美托咪定辅助全身麻醉对功能性鼻内镜鼻窦手术患者氧化应激水平和炎性因子的影响

Effects of Dezocine Combined with Low-dose Dexmedetomidine on Oxidative Stress Levels and Inflammatory Factors in Patients Undergoing Functional Endoscopic Sinus Surgery

目的:观察地佐辛联合小剂量右美托咪定辅助全身麻醉对功能性鼻内镜鼻窦手术患者氧化应激水平和炎性因子的影响。方法:选取2013年6月到2018年6月期间于我院接受功能性鼻内镜鼻窦手术的患者130例,根据信封抽签法将患者分为对照组(n=65,单纯全身麻醉)和实验组(n=65,地佐辛联合小剂量右美托咪定辅助全身麻醉),对比两组血流动力学、氧化应激和炎性因子水平,记录两组苏醒期躁动情况及呛咳发生率。结果:两组插管前(T1)~拔管后5 min(T4)心率(HR)、平均动脉压(MAP)呈升高后降低趋势,血氧饱和度(SpO2)呈降低后升高趋势(P<0.05),且实验组HR、MAP低于对照组,SpO2高于对照组(P<0.05)。两组术后1d、术后3d超氧化物歧化酶(SOD)较术前升高,且实验组高于对照组(P<0.05);丙二醛(MDA)较术前降低,且实验组低于对照组(P<0.05)。两组术后1d、术后3d白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)呈降低趋势,且实验组低于对照组(P<0.05)。两组拔管时~拔管后10 min Riker镇静躁动评分(SAS)评分呈降低趋势,且实验组低于对照组(P<0.05)。实验组的呛咳发生率较对照组低(P<0.05)。结论:地佐辛联合小剂量右美托咪定辅助全身麻醉用于功能性鼻内镜鼻窦手术患者,减少苏醒期躁动,预防呛咳发生,使血流动力学维持平稳,减轻机体氧化应激反应和炎性应激反应。

Objective:To observe the effect of dezocine combined with low-dose dexmedetomidine on oxidative stress levels and inflammatory factors in patients undergoing functional endoscopic sinus surgery.Methods:From June 2013 to June 2018,130 patients who received functional endoscopic sinus surgery in our hospital were selected,and patients were divided into control group(n=65,given general anesthesia only)and experimental group(n=65,given dezocine combined with low-dose dexmedetomidine assisted general anesthesia)according to the envelope lottery method.Hemodynamics,oxidative stress and inflammatory factors levels were compared in the two groups,restlessness during awakening and incidence rate of cough in two groups were recorded.Results:The heart rate(HR)and mean arterial pressure(MAP)of the two groups before intubation(T1)~5 min after extubation(T4)increased and then decreased,while the blood oxygen saturation(SpO2)decreased and then increased(P<0.05).HR and MAP of the experimental group were lower than those of the control group,and SpO2 was higher than that of the control group(P<0.05).Superoxide dismutase(SOD)of the two groups at 1 d after operation and 3 d after operation was increased than that before operation,and the experimental group was higher than the control group(P<0.05).The malondialdehyde(MDA)was decreased than that before operation,and the experimental group was lower than the control group(P<0.05).The interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)of the two groups at 1 d after operation and 3 d after operation showed a decrease trend,and the experimental group was lower than the control group(P<0.05).The Riker agitation score(SAS)scores of the two groups at extubation~10 min after extubation showed a decreased trend,and the experimental group was lower than the control group(P<0.05).The incidence rate of cough of experimental group was lower than control group(P<0.05).Conclusion:Dezocine combined with low-dose dexmedetomidine assisted general anesthesia in patients undergoing functional endoscopic sinus surgery,reduce restlessness during recovery period,can effectively prevent cough,maintain stable hemodynamics,and reduce body oxidative stress and inflammatory stress.