右美托咪定对丙泊酚靶控输注复合舒芬太尼麻醉期间麻醉深度的影响

Effects of Dexmedetomidine on the Depth of Anesthesia During Target-controlled Infusion of Propofol Combined with Sufentanil

目的探讨丙泊酚靶控输注与舒芬太尼复合麻醉期间患者采用右美托咪定(DEX)对麻醉深度的影响。方法选取2021年8月至2022年7月在郑州市第三人民医院接受甲状腺次全切除术患者共计90例,均行丙泊酚靶控输注与舒芬太尼复合麻醉,根据随机数字表法分为研究组(n=45)与对照组(n=45),研究组静脉泵注DEX稀释药物+生理盐水,对照组静脉泵注生理盐水(同等剂量),对两组熵指数(EI)变化情况(诱导后、操作时、手术结束后)进行观察,对两组平均动脉压(MAP)、心率(HR)、警觉/镇静评分(OAA/S)进行记录[给药前(T_(0))、给药5 min(T_(1))、给药10 min(T_(2))、给药20 min(T_(3))],统计两组麻醉恢复时间。结果两组诱导后、操作时、手术结束后的反应熵(RE)和状态熵(SE)降低,差异有统计学意义(P<0.05),且研究组与对照组相比更低,差异有统计学意义(P<0.05);两组T_(1)、T_(2)时MAP升高,差异有统计学意义(P<0.05),T_(1)、T_(2)、T_(3)时HR下降,差异有统计学意义(P<0.05),T_(1)、T_(2)、T_(3)时OAA/S评分降低,差异有统计学意义(P<0.05),研究组T_(1)、T_(2)时MAP较对照组更高,差异有统计学意义(P<0.05),研究组T_(2)、T_(3)时HR更低,差异有统计学意义(P<0.05),研究组T_(2)、T_(3)时OAA/S评分更高,差异有统计学意义(P<0.05);研究组呼吸睁眼时间、拔管时间较对照组更短,差异有统计学意义(P<0.05)。结论DEX应用于丙泊酚靶控输注与舒芬太尼复合麻醉患者可提高麻醉质量,稳定血流动力学,镇静效果显著,缩短麻醉恢复时间。

Objective To explore the effect of dexmedetomidine(DEX)on the depth of anesthesia during target-controlled infusion of propofol combined with sufentanil.Methods A total of 90 patients undergoing subtotal thyroidectomy at the Zhengzhou Third People’s Hospital from August 2021 to July 2022 were selected,all of whom received target-controlled infusion of propofol combined with sufentanil anesthesia.they were divided into study group(n=45)and control group(n=45)by random number table method.The study group received intravenous infusion of DEX diluted drug and physiological saline,while the control group received intravenous infusion of physiological saline(at the same dose).The changes of entropy index(EI)of two groups(after induction,during operation,and after surgery)were observed,and the mean arterial pressure(MAP),heart rate(HR),observer's assessment alert/sedation score(OAA/S)before administration(T_(0)),5 min(T_(1)),10 min(T_(2)),and 20 min(T_(3))of the two groups were recorded,and the recovery time of anesthesia was counted.Results The reaction entropy(RE)and state entropy(SE)of the two groups decreased at induction,operation and after operation,the difference was statistically significant(P<0.05),but in comparision of the control group,the study group was higher,the difference was statistically significant(P<0.05).MAP at T_(1),T_(2) in both groups were increased,the difference was statistically significant(P<0.05),HR at T_(1),T_(2),T_(3) were decreased,the difference was statistically significant(P<0.05),OAA/S scores at T_(1),T_(2),T_(3) were decreased,the difference was statistically significant(P<0.05),in comparision of the control group,MAP at T_(1),T_(2) in the study group was higher,the difference was statistically significant(P<0.05),HR at T_(2),T_(3) in the study group was lower,the difference was statistically significant(P<0.05),and OAA/S at T_(2),T_(3) scores in the study group were higher,the difference was statistically significant(P<0.05).In comparision of the control group,in the breathing and eye opening and extubation time,the study group were shorter,the difference was statistically significant(P<0.05).Conclusion The application of DEX in target-controlled infusion of propofol combined with sufentanil during anesthesia can improve the quality of anesthesia,keep the hemodynamics in a stable state,have a significant sedative effect,and shorten the recovery time of anesthesia.