右美托咪定联合去甲肾上腺素在全麻下腰椎手术中对患者围术期循环及术后恢复质量的影响

Effect of Dexmedetomidine Combined with Norepinephrine on Perioperative Circulation and Postoperative Recovery Quality in Patients Undergoing Lower Lumbar Surgery Under General Anesthesia

目的:探究右美托咪定联合去甲肾上腺素在全麻下腰椎手术中对患者围术期循环指标及术后恢复指标的影响。方法:选择2019年1月至2020年12月于我院接受治疗的68例行全麻下腰椎手术患者为研究对象,按照随机、双盲、对照的方式区分为研究组与对照组(每组各34例患者),对照组患者术中应用右美托咪定,研究组患者在对照组基础上加用去甲肾上腺素,对比两组患者围术期血流动力学(血压、心率)变化、术中出血量、手术时间、麻醉时间、术后疼痛度、苏醒指标的影响。结果:比较显示术前(T0)、插管时(T1)两组患者的平均动脉压(Mean arterial pressure,MAP)与心率(heart rate,HR)组间差异不大(P>0.05),但手术30 min(T2)、手术60 min(T3)、手术结束拔管(T4)时研究组MAP和HR均高于对照组(P<0.05);研究组患者术中出血量与对照组比较无明显差异(P>0.05),研究组患者麻醉时间低于对照组患者(P<0.05);研究组患者苏醒躁动评分以及术后6 h疼痛度评分均低于对照组(P<0.05)。结论:全麻下腰椎手术患者联用右美托咪定与去甲肾上腺素能够显著稳定患者围术期血流动力学,缩短麻醉苏醒时间,且不增加术中出血量,不增加患者术后苏醒躁动及应激性疼痛现象,值得临床推广应用。

Objective:To explore the influence of dexmedetomidine combined with norepinephrine on perioperative circulation index and postoperative recovery index in lumbar spine surgery under general anesthesia.Methods:68 patients undergoing lumbar surgery under general anesthesia in our hospital from January 2019 to December 2020 were selected as the research objects,and divided into study group and control group randomly,double-blind,and controlled.Patients in control group were given dexmedetomidine during operation,while patients in study group were given norepinephrine on the basis of control group.The changes of hemodynamics(blood pressure,heart rate)before and after extubation were compared between the two groups.Results:Comparison showed that there was no significant difference in Mean arterial pressure(MAP)and heart rate(HR)between the two groups before operation(T0)and intubation(T1)(P>0.05),but the MAP and HR of the study group were higher than those of the control group at 30 minutes of operation(T2),60 minutes of operation(T3),and extubation(T4)at the end of the operation(P<0.05).There was no significant difference in intraoperative blood loss between the study group and the control group(P>0.05).The anesthesia time of the study group was lower than that of the control group(P<0.05);the study group had a restlessness score and pain score at 6 hours after surgery All lower than the control group(P<0.05).Conclusion:The combination of dexmedetomidine and norepinephrine in patients undergoing lumbar spine surgery under general anesthesia can significantly stabilize perioperative hemodynamics,and does not increase the amount of intraoperative blood loss,and anesthesia time,and improve Allen Su agitation and postoperative pain,which is worthy of clinical application.