右美托咪定复合七氟醚维持麻醉方案对冠心病非心脏手术患者的效果

Effect of Dexmedetomidine Combined with Sevoflurane Maintenance Anesthesia Regimen on Patients with Coronary Heart Disease Undergoing Non-cardiac Surgery

目的:探讨右美托咪定复合七氟醚维持麻醉方案在冠心病非心脏手术患者中的应用效果。方法:选取2021年1月—2023年12月厦门大学附属第一医院收治的100例冠心病非心脏手术患者作为研究对象,按随机数表法分为两组,各50例。对照组给予丙泊酚复合七氟醚维持麻醉,观察组给予右美托咪定复合七氟醚维持麻醉。比较两组生命体征变化、心肌损伤标志物、应激指标、术后镇痛情况及不良事件。结果:观察组T1、T2舒张压、收缩压、心率低于对照组,差异有统计学意义(P<0.05);观察组术后24 h肌酸激酶同工酶、肌钙蛋白I、心型脂肪酸结合蛋白、去甲肾上腺素、皮质醇、促肾上腺皮质激素水平低于对照组,差异有统计学意义(P<0.05);观察组术后6 h、24 h视觉模拟评分法评分低于对照组,术后镇痛泵按压次数少于对照组,差异有统计学意义(P<0.05);两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定复合七氟醚维持麻醉可稳定冠心病非心脏手术患者术中生命体征,降低手术应激反应,减轻心肌损害,且安全性良好。

Objective:To explore the application effect of Dexmedetomidine combined with Sevoflurane maintenance anesthesia regimen in patients with coronary heart disease undergoing non-cardiac surgery.Method:A total of 100 patients with coronary heart disease who underwent non-cardiac surgery who treated in the First Affiliated Hospital of Xiamen University from January 2021 to December 2023 were selected as the study subjects,they were divided into two groups according to the random number table method,with 50 cases in each group.The control group was given Propofol combined with Sevoflurane to maintain anesthesia,and the observation group was given Dexmedetomidine combined with Sevoflurane maintain anesthesia.The changes of vital signs,myocardial injury markers,stress indicators,postoperative analgesia and adverse events were compared between two groups.Result:The diastolic blood pressure,systolic blood pressure and heart rate in the observation group at T1 and T2 were lower than those in the control group,and the differences were statistically significant(P<0.05);the levels of creatine kinase isoenzyme,troponin I,heart-type fatty acid binding protein,norepinephrine,cortisol and adrenocorticotropic hormone in the observation group at 24 h after operation were lower than those in the control group,and the differences were statistically significant(P<0.05);the visual analogue scale scores in the observation group at 6 h and 24 h after operation were lower than those in the control group,and the number of pressing times of postoperative analgesia pump was less than that in the control group,the differences were statistically significant(P<0.05);there was no significant difference in the incidence of adverse events between two groups(P>0.05).Conclusion:Dexmedetomidine combined with Sevoflurane maintenance anesthesia can stabilize the vital signs of patients with coronary heart disease undergoing non-cardiac surgery,reduce the surgical stress response,reduce myocardial damage,and have good safety.