右美托咪定滴鼻对老年患者全麻苏醒质量的影响

Effects of Dexmedetomidine Nasal Drops on the Recovery Quality of General Anesthesia in Elderly Patients

目的:研究右美托咪定滴鼻对老年患者全麻苏醒质量的影响,探讨一种有效的麻醉方法以提高手术安全性。方法:选取本院2019年10月~2020年10月的96例老年手术患者为研究对象,根据不同麻醉方法分为对照组和观察组,每组48例。分别于麻醉诱导前10 min予以1 ml的生理盐水与右美托咪定0.6μg/kg进行滴鼻,两组其他麻醉用药方法相同,对比两组的血流动力学指标(平均动脉压、心率、血氧饱和度)、苏醒质量(自主呼吸恢复时间、睁眼时间、拔管时间)、应激反应指标(皮质醇、肾上腺素、去甲肾上腺素)以及认知功能(MMSE评分)。结果:观察组滴鼻后10 min、插管前、插管时的血流动力学指标优于对照组(P<0.05);观察组的苏醒质量优于对照组(P<0.05);观察组术后的皮质醇、肾上腺素、去甲肾上腺素均低于对照组(P<0.05);观察组术后各时间点的MMSE评分均高于对照组(P<0.05)。结论:右美托咪定滴鼻在老年患者全麻中的应用效果良好,有助于稳定患者术中血流动力学指标,且可提高苏醒质量、减轻应激反应,预防术后发生认知功能障碍。

Objective:To study the effects of dexmedetomidine nasal drip on the quality recovery of general anesthesia in elderly patients,and to explore an effective anesthesia method to improve the safety of operation.Methods:96 cases of elderly surgical patients in our hospital from October 2019 to October 2020 were selected as the research subjects and divided into control group and observation group according to different anesthesia methods,with 48 cases in each group.The two groups were given 1 ml normal saline and 0.6μg/kg dexmedetomidine respectively 10 min before anesthesia induction,the other anesthesia methods of the two groups were the same.The hemodynamic indexes(mean arterial pressure,heart rate,oxygen saturation),quality of recovery(recovery time of spontaneous breathing,time of eye opening and extubation),indexes of stress response(cortisol,epinephrine,norepinephrine)and cognitive function(MMSE score)were compared between the two groups.Results:The hemodynamic indexes of the observation group were better than those of the control group at 10 min after nasal drip,before and during intubation(P<0.05);the awakening quality of the observation group was better than that of the control group(P<0.05);the cortisol,epinephrine and norepinephrine in the observation group were lower than those in the control group(P<0.05);the MMSE scores of the observation group at each time point after operation were higher than those of the control group(P<0.05).Conclusion:Dexmedetomidine nasal drip in elderly patients with general anesthesia has a significant effect,which helps to stabilize the hemodynamic indexes,improve the quality of recovery,reduce the stress reaction,and prevent the occurrence of postoperative cognitive dysfunction.