右美托咪定联合丙泊酚麻醉诱导对高龄全身麻醉手术患者气管插管应激反应的抑制作用

Inhibitory effect of dexmedetomidine combined with propofol anesthesia induction on endotracheal intubation stress response in elderly patients undergoing general anesthesia surgery

目的探讨右美托咪定联合丙泊酚麻醉诱导对高龄全身麻醉手术患者气管插管应激反应的抑制作用。方法选取七星关区人民医院2018年12月—2020年2月收治的接受全身麻醉的手术患者116例,按照摸球法分为对照组与观察组,各58例。对照组采用0.9%氯化钠溶液+丙泊酚麻醉诱导,观察组给予右美托咪定联合丙泊酚诱导麻醉。比较2组气管插管前(T_(0))、气管插管时(T_(1))、切皮时(T_(2))、拔管时(T_(3))和拔管后(T_(4))心率(HR)、舒张压(SBP)、收缩压(DBP),诱导后即刻(T_(0))、插管1 min(T_(1))、插管5 min(T_(2))、插管10 min(T_(3))皮质醇(Cor)、肾上腺素(AD)、去甲肾上腺素(NE),苏醒程度评分、自主呼吸恢复时间、不良反应发生率。结果T_(0)时,2组HR、SBP、DBP比较,差异无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)、T_(4)时,观察组HR、SBP、DBP低于对照组(P<0.05)。T_(0)时,2组Cor、AD、NE水平比较,差异无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)时,观察组Cor、AD、NE水平低于对照组(P<0.05)。观察组苏醒程度评分高于对照组,自主呼吸恢复时间短于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论右美托咪定联合丙泊酚麻醉诱导在高龄全身麻醉手术患者中的应用效果良好,可平衡患者血液流变学水平及肾功能,抑制气管插管应激反应,提升苏醒质量,且安全性较高。

Objective To investigate the inhibitory effect of dexmedetomidine combined with propofol anesthesia induction on tracheal intubation stress response in elderly patients undergoing general anesthesia.Methods A total of 116 cases of patients who received general anesthesia were selected from December 2018 to February 2020 in Bijie Qixingguan District People's Hospital,which were divided into control group and observation group according to the method of touching the ball,58 cases in each group.The control group was induced by 0.9%sodium chloride solution and propofol anesthesia.The observation group was given right metomidine combined with propofol to induce anesthesia.The results showed that the two groups were compared with before intubation(T_(0)),during endotracheal intubation(T_(1)),during skin cutting(T_(2)),during extubation(T_(3))and after extubation(T_(4))HR,SBP and DBP;The changes of immediately after induction(T_(0)),intubation for 1 min(T_(1)),intubation for 5 min(T_(2))and intubation for 10 min(T_(3))Cor,AD and NE were observed immediately after induction;The recovery time of spontaneous respiration and the incidence of adverse reactions were evaluated.Results At T0,there was no significant difference in HR,SBP and DBP between the two groups(P>0.05);at T_(1),T_(2),T_(3),T_(4),the HR,SBP and DBP of observation group were lower than those in control group(P<0.05).At T_(0),the level of Cor,AD and NE in the two groups was not statistically significant(P>0.05);at T_(1),T_(2),T_(3),T_(4),the levels of Cor,AD and NE in observation group were lower than those in control group(P<0.05)The observation group of recovery score was higher than control group,the recovery time of spontaneous respiration was shorter in observation group than in control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion Dexmedetomidine combined with propofol anesthesia induction in elderly patients with general anesthesia surgery has good effect,balance the level of Hemorheology and renal function,inhibit the stress response of tracheal intubation,improve the quality of recovery,and with high safety.