丙泊酚与七氟醚配合右美托咪定对老年腹腔镜下肿瘤切除手术患者血流动力学影响的比较

Effect of propofol and sevoflurane combined with dexmedetomidine on hemodynamics in elderly patients undergoing laparoscopic tumor resection

[目的]对比分析丙泊酚与七氟醚配合右美托咪定对老年腹腔镜下肿瘤切除手术患者血流动力学的影响。[方法]选择老年腹腔镜下肿瘤切除手术患者94例,按照随机数字表法分为丙泊酚配合右美托咪定麻醉组(A组),七氟醚配合右美托咪定麻醉组(B组),各47例。比较2组手术时间、出血量和麻醉时间,术前、术后3 h和术后6 h MMSE评分,不同时刻血流动力学指标变化。[结果]A组与B组手术时间、出血量和麻醉时间及呼吸抑制、恶性呕吐及低血压等不良反应比较均差异无统计学意义(P>0.05)。2组术前MMSE评分比较差异无统计学意义(P>0.05),A组术后3 h和术后6 h MMSE评分均高于B组(P<0.05)。2组麻醉诱导前心率、舒张压、收缩压和平均动脉压变化比较差异无统计学意义(P>0.05),而A组麻醉诱导后、插管时和拔管后舒张压、收缩压高于B组,而平均动脉压低于B组(P<0.05)。[结论]丙泊酚配合右美托咪定对老年腹腔镜下肿瘤切除手术患者血流动力学影响小,且对术后认知功能影响小,值得临床借鉴。

[Objective]To compare the effects of propofol and sevoflurane combined with dexmedetomidine on hemodynamics in elderly patients undergoing laparoscopic tumor resection.[Methods]Ninety-four elderly patients with laparoscopic tumor resection were selected and randomly divided into control group(47 cases)and observation group(47 cases).Group A was anesthetized with propofol and dexmedetomidine,group B was anesthetized with sevoflurane and dexmedetomidine.The operation time,blood loss and anesthesia time,MMSE score before operation,3 hours and 6 hours after operation,and the changes of hemodynamic indexes at different times were compared between the two groups.[Results]There was no significant difference in operation time,blood loss,anesthesia time,respiratory depression,malignant vomiting and hypotension between the two groups(P>0.05).There was no significant difference in MMSE scores between the two groups before operation(P>0.05).MMSE scores at 3 h and 6 h after operation in group A were higher than those in group B(P<0.05).There was no significant difference in HR,DBP,SBP and map at to between the two groups(P>0.05),but DBP and SBP at T1,T2 and T3 in group A were higher than those in group B,while map was lower than that in group B(P<0.05).[Conclusion]Propofol combined with dexmedetomidine has little effect on hemodynamics and postoperative cognitive function in elderly patients undergoing laparoscopic tumor resection,which is worthy of clinical reference.