右美托咪定在冠心病患者全身麻醉中的应用价值

Application Value of Dexmedetomidine in General Anesthesia in Patients with Coronary Heart Disease

目的探讨冠心病患者全身麻醉时使用右美托咪定的效果。方法便利选取2019年12月—2020年12月厦门市第五医院90例冠心病患者为研究对象,全部行全麻。随机分成对照组(常规麻醉)、观察组(静脉泵注右美托咪定),各45例,观察两组麻醉效果。结果观察组拔管时、拔管后的心率(HR)(72.81±6.91)、(64.89±7.82)次/min,舒张压(DBP)(73.12±11.03)、(66.13±9.86)mmHg明显低于对照组的(81.59±7.90)次/min、(74.42±7.55)次/min,(89.21±10.05)mmHg、(87.95±10.23)mmHg,拔管后的收缩压(SBP)(121.34±22.57)mmHg明显低于对照组的(143.01±30.11)mmHg,差异有统计学意义(t=5.612、5.881、7.233、10.302、3.863,P<0.05)。观察组给药后10、20、30 min的BIS值低于对照组,差异有统计学意义(t=16.644、18.725、21.374,P<0.05);观察组给药30 min的镇静、镇痛效果均优于对照组,差异有统计学意义(t=7.844、5.319、7.186、5.554,P<0.05)。结论冠心病患者予以全麻时使用右美托咪定能够有效镇静和镇痛。

Objective To discuss the effect of dexmedetomidine during general anesthesia in patients with coronary heart disease.Methods 90 patients with coronary heart disease in Xiamen Fifth Hospital from December 2019 to December 2020 were conveniently selected as the study objects,and all of them received general anesthesia.Randomly divided into control group(conventional anesthesia)and observation group(intravenous infusion of dexmedetomidine),45 cases in each group,and the anesthesia effect was observed between two groups.Results The heart rate(HR)(72.81±6.91)times/min,(64.89±7.82)times/min,diastolic pressure(DBP)(73.12±11.03)mmHg,(66.13±9.86)mmHg in the observation group were significantly lower than those in the control group(81.59±7.90)times/min,(74.42±7.55)times/min,(89.21±10.05)mmHg,(87.95±10.23)mmHg,and the systolic pressure(SBP)after extubation(121.34±22.57)mmHg were significantly lower than those in the control group(143.01±30.11)mmHg,the difference was statistically significant(t=5.612,5.881,7.233,10.302,3.863,P<0.05).The BIS values at 10,20 and 30 min after administration in the observation group were lower than those in the control group,the difference was statistically significant(t=16.644,18.725,21.374,P<0.05).The effect of sedation and analgesia after 30 minutes after administration in the observation group were better than those in the control group,the difference was statistically significant(t=7.844,5.319,7.186,5.554,P<0.05).Conclusion Dexmedetomidine is effective for sedation and analgesia in patients with coronary heart disease under general anesthesia.