氟比洛芬酯联合右美托咪定在颈丛甲状腺手术中的应用及对皮质醇和IL-6的影响

Application of Flurbiprofen Axetil Combined with Dexmedetomidine in Cervical Plexus Thyroid Surgery and Its Effect on Cortisol and IL-6

目的分析氟比洛芬酯联合右美托咪定在颈丛甲状腺手术中的应用及对皮质醇和白细胞介素-6(IL-6)的影响。方法入组2019年1月—2020年1月该院收治的颈丛甲状腺手术患者共70例,随机分组,每组35例,对照组的患者给予颈丛阻滞辅助氟比洛芬酯麻醉,观察组给予颈丛阻滞辅助氟比洛芬酯联合右美托咪定麻醉。比较两组出麻醉恢复室时间、特定时间患者心率以及平均动脉压、皮质醇和IL-6、麻醉优良率、躁动发生率。结果观察组出麻醉恢复室时间(15.21±2.04)min短于对照组(38.21±3.12)min,差异有统计学意义(t=7.978,P<0.05),观察组心率(HR)在切皮时(54.21±5.21)次/min、病灶分离时(63.56±2.58)次/min、手术缝皮时(65.36±3.53)次/min明显低于对照组患者,差异有统计学意义(P<0.05)。观察组病灶分离时皮质醇(114.56±13.21)nmol/L、IL-6(104.19±8.35)pg/mL低于对照组(263.34±25.78)nmol/L、(210.11±18.21)pg/mL,差异有统计学意义(t=12.323、15.822,P<0.05)。观察组麻醉优良率94.29%高于对照组74.29%,差异有统计学意义(χ^(2)=5.285,P<0.05)。观察组无出现躁动,而对照组有6例出现躁动,发生率是17.14%,差异有统计学意义(χ^(2)=7.353,P<0.05)。结论氟比洛芬酯联合右美托咪定在颈丛甲状腺手术中的应用效果确切,可减轻机体不良应激,维持患者术中生命体征稳定,减少躁动的发生。

Objective To analyze the application of flurbiprofen axetil combined with dexmedetomidine in cervical plexus thyroid surgery and its effect on cortisol and IL-6.Methods A total of 70 cervical plexus thyroid surgery patients admitted to the hospital from January 2019 to January 2020 were enrolled.They were randomly divided into groups,35 cases in each group.Patients in the control group were given cervical plexus block adjuvant flurbiprofen axetil anesthesia,the observation group was given cervical plexus block assisted flurbiprofen axetil combined with dexmedetomidine anesthesia.The time of leaving the anesthesia recovery room,the heart rate and mean arterial pressure,cortisol and IL-6,the excellent and good rate of anesthesia,and the incidence of agitation were compared between the two groups.Results The observation group's time to leave the anesthesia recovery room was(15.21±2.04)min,which was shorter than the control group(38.21±3.12)min,the difference was statistically significant(t=7.978,P<0.05),the observation group's HR was(54.21±5.21)times/min when the skin was cut and(63.56±2.58)times/min when the lesion was separated,(65.36±3.53)times/min when sutured the skin during operation were significantly lower than those in the control group,the difference was statistically significant(P<0.05).Cortisol(114.56±13.21)nmol/L and IL-6(104.19±8.35)pg/mL in the observation group were lower than those in the control group at(263.34±25.78)nmol/L and(210.11±18.21)pg/mL,the difference was statistically significant(t=12.323,15.822,P<0.05).The excellent and good rate of anesthesia in the observation group was 94.29%higher than that in the control group 74.29%,the difference was statistically significant(χ^(2)=5.285,P<0.05).There was no restlessness in the observation group,while 6 cases in the control group showed restlessness,the incidence was 17.14%,the difference was statistically significant(χ^(2)=7.353,P<0.05).Conclusion The effect of flurbiprofen axetil combined with dexmedetomidine in cervical plexus and thyroid surgery is definite,which can reduce the body's adverse stress,maintain the stability of the patient's vital signs during the operation,and reduce the occurrence of restlessness.