羟考酮联合右美托咪定对老年胃肠手术全麻患者术后苏醒期躁动及应激反应的影响

Effects of Oxycodone Combined with Dexmedetomidine on Agitation and Stress Response during Postoperative Recovery Period in Elderly Patients Undergoing General Anesthesia of Gastrointestinal Surgery

目的:分析羟考酮联合右美托咪定对老年胃肠手术全麻患者术后苏醒期躁动及应激反应的影响。方法:选取本院2018年8月-2019年10月收治的老年胃肠手术全麻患者68例,根据随机数字表法分为两组,各34例。对照组采用羟考酮治疗,在此基础上,观察组联合右美托咪定治疗,对比两组躁动情况、苏醒期情况、胰岛素抵抗指标和甲状腺指标。结果:观察组Riker镇静-躁动评分低于对照组(P<0.05);观察组自主呼吸时间、苏醒时间早于对照组(P<0.05);观察组拔管时间长于对照组(P<0.05);观察组FINS、FBG、HOMA-IR、TSH、FT_(4)和FT_(3)水平均低于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:老年胃肠手术全麻患者接受羟考酮与右美托咪定的联合干预,可有效减轻术后苏醒期躁动和应激反应,降低不良反应的发生,安全性较高,值得应用。

Objective:To analyze the effect of Oxycodone combined with Dexmedetomidine on agitation and stress response during postoperative recovery period in elderly patients with general anesthesia during gastrointestinal surgery.Method:A total of 68 elderly patients admitted to our hospital from August 2018 to October 2019 for general anesthesia in gastrointestinal surgery were selected and divided into two groups according to the random number table method,34 patients in each group.The control group was treated with Oxycodone.On this basis,the observation group was treated with Dexmedetomidine,and the agitation,awakening period,insulin resistance and thyroid indexes of the two groups were compared.Result:The Riker sedation-restlessness score of the observation group was lower than that of the control group(P<0.05);the spontaneous breathing time and the recovery time of the observation group were earlier than those of the control group(P<0.05);the extubation time of the observation group was longer than that of the control group(P<0.05).The levels of FINS,FBG,HOMA-IR,TSH,FT_(4) and FT_(3) in the observation group were lower than those in the control group(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combined intervention of Oxycodone and Dexmedetomidine in elderly patients undergoing general anesthesia for gastrointestinal surgery can effectively reduce postoperative agitation and stress response during the recovery period,and reduce the occurrence of adverse reactions.It is safe and worthy of application.