Effect of dexmedetomidine on hemodynamics and recovery from general anesthesia in patient undergoing abdominal surgery
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摘要: 目的 探讨右美托咪定对全麻胃肠手术患者苏醒期恢复和血流动力学的影响。 方法 选择浙江省肿瘤医院2013年1月-2015年12月胃肠外科全麻手术患者148例作为研究对象,将其分为右美托咪定组和对照组,右美托咪定组麻醉诱导前给予右美托咪定泵注,对照组麻醉诱导前给予咪达唑仑静滴。观察2组患者麻醉诱导期、手术期、拔管期的血流动力学变化,并观察2组患者拔管后Ramsay镇静评分和RASS评分情况。 结果 右美托咪定组插管时、插管5 min、插管10 min的收缩压、舒张压、平均动脉压、心率低于入手术室时(P<0.05);对照组插管时、插管5 min的收缩压、舒张压、平均动脉压、心率均高于入手术室时(P<0.05),且高于右美托咪定组(P<0.05)。右美托咪定组手术期及拔管期各时间段收缩压、舒张压、平均动脉压、心率与切皮时比较均无明显变化(P>0.05);对照组胃肠探查和胃肠切除时的收缩压、舒张压、平均动脉压、心率均高于切皮时(P<0.05),且高于右美托咪定组(P<0.05)。对照组拔管1 min、拔管5 min、拔管10 min时的收缩压、舒张压、平均动脉压、心率均高于拔管前(P<0.05),且高于右美托咪定组(P<0.05)。右美托咪定组拔管后10 min、拔管后20 min的Ramsay镇静评分均明显高于对照组(P<0.05),右美托咪定组拔管后10 min、拔管后20 min的RASS评分均明显低于对照组(P<0.05)。 结论 右美托咪定可以稳定全麻胃肠手术患者围手术期血流动力学,有利于苏醒期的恢复。Abstract: Objective To explore the effect of dexmedetomidine on hemodynamics and recovery from general anesthesia in patient undergoing abdominal surgery. Methods Total 148 patients undergoing gastrointestinal operation in Zhejiang Cancer Hospital from January,2013 to December,2015 were selected and divided into dexmedetomidine group and control group.Dexmedetomidine group were given dexmedetomidine with an infusion pump before the induction of anesthesia,while the control group were given midazolam before the induction of anesthesia.The hemodynamic changes during the induction of anesthesia,operation and extubation in the two groups were observed,and the Ramsay sedation score and RASS score were observed after extubation. Results In dexmedetomidine group,the systolic blood pressure,diastolic blood pressure,mean arterial pressure and heart rate at intubation,5 min after intubation and 10 min after intubation were all lower than those before the anesthesia procedures beginning (P<0.05);the result was reversed in the control group (P<0.05),and the difference between the two groups was significant (P<0.05).In the dexmedetomidine group,systolic blood pressure,diastolic blood pressure and mean arterial pressure and heart rate at each time of surgery and extubation did not change significantly (P>0.05);But in the control group,these observed items at gastrointestinal exploration and section were elevated significantly as compared with the values at the incision (P<0.05),and all were higher than those of the dexmedetomidine group (P<0.05).The systolic blood pressure,diastolic blood pressure and mean arterial pressure and heart rate at 1 min,5 min and 10 min after the extubation were all higher than before the extubation (P<0.05),which were higher than those of the dexmedetomidine group (P<0.05).The Ramsay sedation scores of dexmedetomidine group at 10 min and 20 min after the extubation were significantly higher than those of the control group (P<0.05),the RASS scores of dexmedetomidine group at 10 min and 20 min after the extubation were significantly lower than those of the control group (P<0.05). Conclusion Dexmedetomidine can stabilize perioperative hemodynamics of patient abdominal surgery,and help the restore of patients from general anesthesia.
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Key words:
- Dexmedetomidine /
- General anesthesia /
- Gastrointestinal operation /
- Hemodynamics
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