右美托咪定辅助全身麻醉对腹腔镜直肠癌根治术患者的影响

Effects of Dexmedetomidine-assisted General Anesthesia on Patients Undergoing Laparoscopic Radical Rectal Cancer Surgery

目的:右美托咪定辅助全身麻醉对腹腔镜直肠癌根治术患者镇痛效果及血流动力学指标的影响。方法:选取2021年1月—2022年4月于新泰市人民医院行腹腔镜直肠根治术患者48例为研究对象,按随机数字表法分为对照组与观察组,各24例。两组均给予全身麻醉,观察组于麻醉诱导前10 min静脉泵注右美托咪定,对照组给予同剂量的生理盐水。对比两组镇痛效果、血流动力学指标、应激反应指标及不良反应。结果:观察组患者镇痛起效时间、镇痛持续时间优于对照组,差异有统计学意义(P<0.001)。插管时(T_(1))、手术开始后30 min(T_(2))、术毕时(T_(3)),对照组患者心率(HR)、平均动脉压(MAP)低于观察组,差异有统计学意义(P<0.05);T_(1)、T_(2)、T_(3),对照组患者HR、MAP低于麻醉前(T_(0)),差异有统计学意义(P<0.05)。T_(1)、T_(2)、T_(3),观察组患者皮质醇(Cor)、去甲肾上腺素(NE)低于对照组,差异有统计学意义(P<0.001);T_(1)、T_(2)、T_(3),观察组与对照组患者Cor、NE高于T_(0),差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定辅助全身麻醉在腹腔镜直肠癌根治术患者中镇痛效果明显,能够稳定其血流动力学,减轻应激反应,且无严重不良反应。

Objective:The effect of dexmedetomidine-assisted general anesthesia on analgesic effect and hemodynamic indexes of patients undergoing laparoscopic radical rectal cancer surgery.Methods:Forty-eight patients who underwent laparoscopic radical rectal surgery in Xintai People's Hospital from January 2021 to April 2022 were selected as the study subjects,and were divided into the control group and the observation group according to the method of randomized numerical table,each of which consisted of twenty-four cases.Both groups were given general anesthesia,and dexmedetomidine was injected intravenously 10 min before the induction of anesthesia in the observation group,and the same dose of saline was given to the control group.The analgesic effect,hemodynamic indexes,stress reaction indexes and adverse reactions of the two groups were compared.Results:The onset of analgesia and duration of analgesia of patients in the observation group were better than those in the control group,and the difference was statistically significant(P<0.001).At the time of intubation(T_(1)),30 min after the start of surgery(T_(2)),and at the end of surgery(T_(3)),the heart rate(HR)and mean arterial pressure(MAP)of the patients in the control group were lower than those in the observation group,and the difference was statistically significant(P<0.05).At T_(1),T_(2) and T_(3),HR and MAP of the control group patients were lower than those before anesthesia(T_(0)),and the difference was statistically significant(P<0.05).T_(1),T_(2),T_(3),cortisol(Cor)and norepinephrine(NE)of patients in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.001).T_(1),T_(2) and T_(3),Cor and NE were higher than T_(0) in patients of the observation and control groups,and the difference was statistically significant(P<0.05).Comparison of the incidence of adverse reactions between the two groups of patients,the difference was not statistically significant(P>0.05).Conclusion:Dexmedetomidine-assisted general anesthesia has obvious analgesic effect in patients undergoing laparoscopic radical rectal cancer surgery,which can stabilize their hemodynamics,reduce stress reactions,and have no serious adverse reactions.