右美托咪定复合瑞芬太尼麻醉在行导管射频消融术心房颤动患者中的应用

Dexmedetomidine Combined with Remifentanil Anesthesia in Application of Atrial Fibrillation Patients Undergoing Transcatheter Radiofrequency Ablation

目的观察右美托咪定复合瑞芬太尼在行导管射频消融术心房颤动患者中的应用效果。方法选取2019年3月—2020年10月收治的行导管射频消融术心房颤动95例,据麻醉方法不同分为研究组(52例)和对照组(43例)两组。研究组采用右美托咪定复合瑞芬太尼麻醉,对照组采用瑞芬太尼麻醉。比较两组入室时及手术开始后10 min(T1)、手术开始后30 min(T2)、手术开始后60 min(T3)、手术开始后120 min(T4)、术毕(T5)血流动力学相关指标,T1~T5时Ramsay镇静评分,手术时间、术中瑞芬太尼追加剂量、苏醒时间、定向力恢复时间,以及术中麻醉不良反应发生情况。结果研究组T1和T2时心率和平均动脉压低于对照组,T3和T4时呼吸和脉搏氧饱和度快于或高于对照组;不同时间点(T1~T5)Ramsay镇静评分高于对照组(P<0.05或P<0.01)。研究组术中瑞芬太尼追加剂量少于对照组(P<0.01)。术中麻醉不良反应总发生率两组比较差异无统计学意义(P>0.05)。结论右美托咪定复合瑞芬太尼应用于行导管射频消融术心房颤动患者,有良好镇静镇痛作用,还可维持血流动力学稳定,减少术中瑞芬太尼使用剂量,且安全性好。

Objective To investigate the effect of Dexmedetomidine combined with Remifentanil anesthesia in application of atrial fibrillation(AF)patients with transcatheter radiofrequency ablation.Methods A total of 95 AF patients treated by transcatheter radiofrequency ablation between March 2019 and October 2020 were selected,and the patients were divided into research group(n=52)and control group(n=43)according to different anesthesia methods.Research group was anesthetized with Dexmedetomidine combined with Remifentanil,while control group was anesthetized with Remifentanil alone.Hemodynamic-related indicators at the time of entering the room,at the 10^(th) min after beginning operation(T1),at 30^(th) min after beginning operation(T2),at 60^(th) min after beginning operation(T3),at 120^(th) min after beginning operation(T4)and at the time after operation immediately(T5)were compared between two groups.Ramsay sedation scores at T1-T5,operative duration,intraoperative dose of additional Remifentanil,recovery time,orientation recovery time,and incidence rate of adverse reactions during operative anesthesia were compared between two groups.Results In research group,levels of heart rates(HR)and mean artery pressure(MAP)at T1 and T2 were significantly lower,while respiration rates(RR)and pulse oxygen saturation(SpO_(2))at T3 and T4 were significantly faster or higher,and Ramsay Sedation scores at different time points(T1-T5)were significantly higher than those in control group(P<0.05 or P<0.01).The intraoperative dose of additional Remifentanil in research group was significantly lower than that in control group(P<0.01),but there was no statistically significant difference in the total incidence rate of adverse reactions between two groups(P>0.05).Conclusion Dexmedetomidine combined with Remifentanil in application of patients with AF undergoing transcatheter radiofrequency ablation may provide effective sedative and analgesic effects,maintain hemodynamic stability and reduce Remifentanil dosage during operation with good safety.