右美托咪定对椎管内麻醉手术患者应激反应的影响

Effects of dexmedetomidine on stress response in patients undergoing intraspinal anesthesia

目的观察右美托咪定对椎管内麻醉手术患者应激反应的影响。方法选取2019年7月至2020年7月收治的在硬膜外麻醉下行腹股沟疝修补术的患者90例,根据随机数字表法将患者分为对照组和试验组,每组45例。对照组患者麻醉中应用丙泊酚,试验组应用右美托咪定,比较2组患者用药前后的心率、听觉诱发电位指数(AAI)、血浆皮质醇激素水平和不良反应发生的情况。结果术前一般资料比较,试验组与对照组差异无统计学意义(P>0.05)。试验组与对照组用药后与用药前比较,2组患者AAI、心率及血浆皮质醇激素水平均有所降低,且试验组用药后AAI、心率及血浆皮质醇激素浓度明显低于对照组,差异有统计学意义(P<0.05)。2组患者均出现头晕、恶心、呕吐、呼吸抑制、低血压及皮肤瘙痒等不良反应,但试验组患者不良反应的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定可显著降低椎管内麻醉手术患者的应激反应,并且较为安全。

Objective To investigate the effects of dexmedetomidine on stress response in patients undergoing intraspinal anesthesia.Methods A total of 90 patients who underwent inguinal herniorrhaphy under epidural anesthesia in our hospital from July 2019 to July 2020 were enrolled in the study,who were divided into control group(n=45)and experimental group(n=45)according to random digits table,with 45 cases in each group.The patients in control group were given propofol for epidural anesthesia,however,the patients in experimental group were given dexmetomidine for epidural anesthesia.The heart rate,auditory evoked potential index(AAI),plasma corticosteroid level and adverse reactions were obseved and compared between the two groups.Results Before surgery there were no significant differences in general data between the two groups(P>0.05).After surgery the AAI,heart rate and plasma cortisol levels in both groups were decreased,moreover,which in experimental group were significantly lower than those in control group(P<0.05).In addition the incidence rates of adverse reactions including nausea,vomiting,dizziness,respiratory depression,hypotension and skin pruritus occurred in in experimental group were significantly lower than those in control group(P<0.05).Conclusion Dexmedetomidine can significantly relieve the stress response of patients undergoing intraspinal anesthesia,with better safety.