右美托咪定对老年腹腔手术患者围手术期相关不良事件的影响

Effects of dexmedetomidine on perioperative related adverse events in elderly patients undergoing abdominal surgery

目的探讨右美托咪定对老年腹腔手术患者围手术期相关不良事件的影响。方法选取2017年4月—2021年4月在海口市妇女儿童医院就诊行全身麻醉下老年腹腔手术患者92例,按数字表法随机分为观察组(n=46)和对照组(n=46)。对照组的辅助麻醉诱导采用常规生理盐水,观察组的辅助麻醉诱导采用右美托咪定。评估并比较2组围手术期平均血压及平均心率、心肌功能[心肌肌钙蛋Ⅰ(cTnⅠ)、N-末端脑利钠肽原(NT-proBNP)]及术后1个月的相关不良事件发生率。结果围手术期观察组T1、T2、T3时刻平均收缩压、舒张压及平均心率均明显高于对照组(P<0.05),T4时刻平均收缩压、舒张压及平均心率均明显低于对照组(P<0.05)。说明围手术期观察组血压及心率稳定性更优于对照组。术后2组cTnⅠ和NT-proBNP均明显高于同组术前(P<0.05),观察组cTnⅠ和NT-proBNP显著低于对照组(P<0.05)。术后1个月,2组相关不良事件发生率差异无统计学意义(P>0.05)。结论右美托咪定可稳定手术期患者的血压和心率,且术后心肌功能得到改善,为手术的顺利开展提供辅助条件。但右美托咪定未能明显减少相关并发症的发生。

Objective To investigate the effects of dexmedetomidine on perioperative related adverse events in elderly patients undergoing abdominal surgery.Methods Ninety two elderly patients undergoing abdominal surgery under general anesthesia in Women’s and Children’s Hospital of Haikou City from April 2017 to April 2021 were selected and divided into observation group(n=46)and control group(n=46)according to the number table.The auxiliary anesthesia induction of the control group used conventional normal saline,and the auxiliary anesthesia induction of the observation group used dexmedetomidine.The perioperative mean blood pressure and mean heart rate,myocardial function[cardiac troponinⅠ(cTnⅠ),N-terminal probrain natriuretic peptide(NT-proBNP)]and the incidence of related adverse events 1 month after operation were evaluated and compared between the two groups.Results The mean systolic blood pressure,mean diastolic blood pressure and mean heart rate at T1,T2,and T3 during the perioperative period of the observation group were significantly higher than those of the control group(P<0.05),and the mean systolic blood pressure,mean diastolic blood pressure and mean heart rate at T4 were significantly lower than those of the control group(P<0.05),which indicated that the stability of blood pressure and heart rate of the observation group during the perioperative period were better than those of the control group.The level of cTnⅠand NT-proBNP of the two groups after operation were significantly higher than those of the same group before operation(P<0.05),and above indexes of the observation group were significantly lower than those of the control group(P<0.05).One month after operation,there was no significant difference in the incidence of related adverse events between the two groups(P>0.05).Conclusion Dexmedetomidine can stabilize the blood pressure and heart rate of patients during operation,and improve the postoperative myocardial function,which provides auxiliary conditions for the smooth operation.However,dexmedetomidine can not significantly reduce the incidence of related complications.