右美托咪定联合瑞芬太尼对心房颤动射频消融术患者的影响

Effects of Dexmedetomidine Combined with Remifentanil on Patients with Atrial Fibrillation Undergoing Radiofrequency Ablation

目的:探讨右美托咪定联合瑞芬太尼对心房颤动射频消融术患者的影响。方法:选取2021年9月—2022年10月绵阳市中心医院·电子科技大学医学院附属绵阳医院收治的80例心房颤动射频消融术患者作为研究对象。根据随机数表法将其分为对照组和观察组,各40例。对照组给予瑞芬太尼,观察组在此基础上给予右美托咪定。比较两组入室时(T_(0))、手术开始后5 min(T_(1))、手术开始后20 min(T_(2))、手术结束后5 min(T_(3))血流动力学指标、应激指标,恢复指标及认知功能。结果:T_(1)、T_(2)、T_(3),观察组心率(heart rate,HR)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)水平均低于对照组,差异有统计学意义(P<0.05)。T_(1)、T_(2)、T_(3),观察组皮质醇(cortisol,Cor)、去甲肾上腺素(norepinephrine,NA)、血糖(blood glucose,GLU)水平均低于对照组,差异有统计学意义(P<0.05)。观察组呼唤睁眼时间、定向力恢复时间均显著早于对照组,差异有统计学意义(P<0.05)。观察组术后认知功能障碍发生率低于对照组,差异有统计学意义(P<0.05)。结论:进行心房颤动射频消融术时,通过右美托咪定联合瑞芬太尼麻醉能够在一定程度上稳定其血流动力学,减轻应激反应,提高麻醉复苏质量,减轻对术后认知功能的影响。

Objective:To investigate the effects of Dexmedetomidine combined with Remifentanil on patients with atrial fibrillation undergoing radiofrequency ablation.Method:A total of 80 patients with atrial fibrillation undergoing radiofrequency ablation admitted to Mianyang Central Hospital·Mianyang Hospital Affiliated to University of Electronic Science and Technology of China from September 2021 to October 2022 were selected as the study objects.They were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group was given Remifentanil,and the observation group was given Dexmedetomidine on this basis.Hemodynamic indexes,stress indexes at entry(T_(0)),5 minutes after the start of surgery(T_(1)),20 minutes after the start of surgery(T_(2)),and 5 minutes after the end of surgery(T_(3)),recovery indexes and cognitive function were compared between the two groups.Result:T_(1),T_(2) and T_(3),heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The levels of cortisol(Cor),norepinephrine(NA)and blood glucose(GLU)in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).The calling eye opening time and orientation recovery time in the observation group were significantly earlier than those in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative cognitive dysfunction in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:When performing radiofrequency ablation of atrial fibrillation,anesthesia with Dexmedetomidine combined with Remifentanil can stabilize its hemodynamics to a certain extent,reduce stress reactions,improve the quality of anesthesia recovery,and reduce the impact on postoperative cognitive function.