不同剂量右美托咪定对腹腔镜下胃肠手术老年患者围术期应激反应的影响

发布时间：2019-03-03 10:16

【摘要】：目的观察不同剂量右美托咪定对腹腔镜下胃肠手术老年患者围术期应激反应的影响。方法择期行腹腔镜下胃肠手术老年患者80例,性别不限,年龄≥65岁,ASAⅠ或Ⅱ级。随机分为四组,每组20例。所有患者均采用全凭静脉麻醉。D1、D2组和D3组麻醉诱导前10min静脉泵注右美托咪定0.5μg/kg,插管后分别静脉泵注右美托咪定0.2、0.5、0.8μg·kg~(-1)·h~(-1)至术毕前30min;C组麻醉诱导前10min静脉泵注7ml生理盐水,插管后静脉泵注生理盐水10ml/h至术毕前30min。记录术中麻醉药物用量,记录给药前(T_0)、气管插管后即刻(T_1)、气腹后5min(T_2)、气腹后60min(T_3)、拔管后即刻(T_4)和拔管后10min(T_5)的HR、SBP、DBP,分别于T_0、T_1、T_3、T_5时抽取桡动脉血,测定Glu、Cor、E和NE浓度。结果 D1组、D2组和D3组术中瑞芬太尼的用量明显少于C组,且D2组和D3组明显少于D1组(P0.05)。与T_0时比较,T_1~T_5时C组HR明显增快(P0.05)。T_2~T_5时,D2组和D3组的HR明显慢于C组和D1组,SBP明显低于C组(P0.05);T_1时D2组和D3组Cor和NE浓度也明显低于C组(P0.05)。T_3和T_5时,D2组和D3组Glu、Cor、E和NE浓度明显低于C组,D2组和D3组Cor和NE浓度明显低于D1组(P0.05)。结论与0.2和0.8μg·kg~(-1)·h~(-1)右美托咪定静脉泵注维持比较,0.5μg·kg~(-1)·h~(-1)能更有效抑制腹腔镜下胃肠手术老年患者围术期应激反应。
[Abstract]:Objective to observe the effect of different doses of dexmetomidine on perioperative stress response in elderly patients undergoing laparoscopic gastrointestinal surgery. Methods 80 elderly patients undergoing laparoscopic gastrointestinal surgery were enrolled in this study. Their age was 鈮，

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