麻醉诱导前低剂量(0.5μg)右美托咪定辅助全麻在胃癌手术患者中的应用研究

Application of low-dose(0.5 μg) dexmedetomidine before anesthesia induction assisted general anesthesia in gastric cancer surgery

目的研究麻醉诱导前低剂量(0.5μg)右美托咪定辅助全麻在胃癌手术患者中的应用效果。方法选取2019年8月至2020年11月于本院接受诊治的122例择期行胃癌手术患者,根据随机数字表法分为观察组与对照组,每组61例。所有患者术前均实施相同的全麻方案,麻醉诱导10 min前,对照组静脉注射0.9%氯化钠溶液,观察组静脉注射低剂量(0.5μg)右美托咪啶,比较两组不同时段生理反应、RSS镇静评分及不良反应发生情况。结果两组患者麻醉前(Tα)、诱导成功即刻(Tβ)时心率(HR)指标与Tα时平均动脉压(MAP)指标比较差异无统计学意义;观察组手术开始时(Ta)、术后30 min(Tb)、手术完成时(Tc)时段HR指标与Tβ、Ta、Tb、Tc时段MAP指标明显低于对照组,差异有统计学意义(P<0.05)。Tα、Tβ、Ta、Tb、Tc时,观察组RSS镇静评分均明显高于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较差异无统计学意义。结论低剂量(0.5μg)右美托咪定辅助全麻可一定程度保证机体血流动力学水平稳定,提高麻醉效果,且安全性高,具有临床推广价值。

Objective To study the application effect of low-dose(0.5 μg) dexmedetomidine before anesthesia induction assisted general anesthesia in gastric cancer surgery. Methods 122 patients who underwent elective gastric cancer surgery in our hospital from August 2019 to November 2020 were selected. They were divided into observation group and control group according to random number table method, with 61 cases in each group. All underwent same general anesthesia before surgery. At 10 min before anesthesia induction, the control group received intravenous injection of 0.9% sodium chloride solution, and the observation group received intravenous injection of low-dose(0.5 μg) dexmedetomidine. The physiological reactions,RSS sedation score and adverse reactions in different periods were compared between the two groups. Results There was no statistically significant difference in heart rate(HR) before anesthesia(Tα) and immediately after induction(Tβ), and mean arterial pressure(MAP) at Tα between two groups.HR of the observation group at the beginning of surgery(Ta), 30 min after surgery(Tb) and the end of surgery(Tc), and MAP at Tβ, Ta, Tb, and Tc were significantly lower than those of the control group, the difference was significant(P<0.05). RSS score in the observation group was higher than the control group at Tα, Tβ, Ta, Tb, and Tc, the difference was significant(P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups. Conclusion Low-dose(0.5 μg) dexmedetomidine assisted general anesthesia can maintain hemodynamic stability, and improve anesthetic effect, the safety is high and it has clinical promotion value.