右美托咪定对腹腔镜直肠癌根治术患者围术期血流动力学的影响

Influence of Dexmedetomidine on Perioperative Hemodynamics of the Patients Undergoing Laparoscopic Radical Procedure for Rectal Cancer

为探讨右美托咪定对腹腔镜直肠癌根治术患者围术期血流动力学的影响,将于我院拟全麻下行腹腔镜直肠癌根治术的100例患者随机分为观察组和对照组,各50例。观察组患者麻醉前予负荷剂量的右美托咪定1.00μg/kg(15min),术中右美托咪定0.5μg/(kg·h)持续泵注至手术结束前30min;对照组予等剂量的生理盐水。比较2组患者麻醉药用量,以及给药前(T0)、气管插管时(T1)、手术开始后30min(T2)、手术缝合时(T3)、拔管即刻(T4)的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)和脑电双频指数(BIS)。结果显示,2组患者丙泊酚、芬太尼、咪唑安定、维库溴铵、瑞芬太尼、阿曲库铵、七氟烷用量比较差异均无统计学意义,P>0.05。T0时刻,2组HR、MAP、SpO2、BIS比较差异均无统计学意义,P>0.05。T1、T2、T3、T4时刻,观察组HR、MAP明显低于对照组,P <0.05;2组SpO2、BIS比较差异无统计学意义,P>0.05。结果表明,右美托咪定有利于减小腹腔镜直肠癌根治术患者围术期血压和心率的波动,维持血流动力学稳定。

This study was to investigate the influence of Dexmedetomidine(Dex.)on perioperative hemodynamics of the patients undergoing laparoscopic radical procedure(LRP)for rectal cancer(RC),randomly divided 100 patients to be subject to LRP under general anesthesia into observation group[50 cases,before anesthesia,Dex.load dosage 1.00μg/kg(15 min);intraoperative dosage:0.5μg/(kg·h)continuously pump-infusing till 30 min before the end of anesthesia]and control group(50 cases,given with equal dosage of normal saline);then compared following indexes as dosage,as well HR,MAP,SpO2 and BIS at T0(before drugs used),T1(when endotracheal intubation),T2(30 min after starting operation),T3(when suture),T4(on the extubation),etc time-points between the two groups.As results,in the dosage of Propofol,Fentanyl,Midazolam,Vecuronium Bromide,Remifentanil,Atracurium,Sevoflurane there was no statistical difference(P>0.05);at T0 HR,MAP,SpO2 and BIS had no statistical difference between the two groups(P>0.05),at T1,T2,T3 and T4 observation groups’HR and MAP were significantly lower than control groups’ones(P<0.05);but SpO2 and BIS had no statistical difference between the two groups(P>0.05).Results show that Dex.is beneficial to reduce BP and HR fluctuating at perioperation,thus maintaing hemodynamics stabilization.