右美托咪定复合氟比洛芬酯在老年高血压全麻中的应用

目的:观察小剂量右美托咪定复合氟比洛芬酯预防老年高血压全麻患者拔管应激反应的效果和安全性。方法:将血压控制稳定、择期行上腹部手术的90例老年患者随机分成生理盐水对照组(A组)、右美托咪定组(B组)、氟比洛芬酯复合右美托咪定组(C组),均于术毕前30 min微泵静脉注射药物,观察MAP、HR变化,测定血浆肾上腺素(E)、去甲肾上腺素(NE)浓度,记录手术相关指标和不良反应发生情况。结果:3组MAP、HR数值和血浆E、NE浓度均比麻醉前明显增高(P<0.01或P<0.05),B组、C组较A组明显平稳(P<0.01或P<0.05),血浆E、NE浓度的变化更小(P<0.01或P<0.05);B组的唤醒时间、拔管时间明显长于A组和C组(P<0.05);C组不良反应发生率明显低于A组与B组(P<0.05)。结论:小剂量右美托咪定复合氟比洛芬酯,能有效预防老年高血压全麻患者气管拔管引起的应激反应及术后躁动的发生率,不延迟唤醒时间和拔管时间,不良反应少。

Application of Compound DexmedeTomidine and Flurbiprofen in General Anesthesia in Elderly Pa tients with Hypertension

Objective To observe the efficacy and safety of low-dose DexmedeTomidine given compound Flurbiprofen in general anesthesia in elderly patients with hypertension the stress reaction during extubation period.Methods Ninety patients with stable blood pressure controlled having elective upper abdominal surgery were randomly divided into three groups,group A(normal saline group),group B(dexmedeTomidine group),and group C(DexmedeTomidine complex flurbiprofen).Intravenous injection by micro-pump was given 30 min before surgery.Changes of MAP and HR,the concentrations of plasma epinephrine(E) and norepinephrine(NE),surgery-related indicators and the incidence of side effects were recorded.Results In all three groups of patients during extubation the MAP,HR values and plasma E and NE concentration changes were higher obviously than those before anesthesia(P < 0.01 or P < 0.05),but significantly smoother in group B,group C than in group A(P<0.01 or P<0.05),plasma E and NE concentration changes were smaller(P<0.01 or P<0.05).In group B the wake-up time and extubation time were significantly longer than those in group A and group C(P<0.05);in group C the incidence of adverse experiences was significantly lower than that in group A and in group B(P < 0.05).Conclusion Low-dose DexmedeTomidine given compound with flurbiprofen can prevent stress response caused by tracheal extubation in elderly hypertensive patients and the incidence of postoperative agitation without delaying the wake-up time and extubation time,and with less adverse reactions.