| 右美托咪定联合丙泊酚麻醉对腹腔镜胆囊切除术患者镇痛效果研究 |
| |
| 引用本文： | 陈显宇,何川. 右美托咪定联合丙泊酚麻醉对腹腔镜胆囊切除术患者镇痛效果研究[J]. 实用肝脏病杂志, 2020, 23(3): 443-446. DOI: 10.3969/j.issn.1672-5069.2020.03.035 |
| |
| 作者姓名： | 陈显宇 何川 |
| |
| 作者单位： | 610081 成都市 四川省林业中心医院麻醉科(陈显宇);成都大学附属医院心血管内科(何川) |
| |
| 基金项目： | 四川省卫生和计划生育委员会科研基金资助项目(编号:17PJ016)。 |
| |
| 摘 要： | 目的 分析应用右美托咪定联合丙泊酚麻醉对腹腔镜胆囊切除术患者镇痛和镇静的效果。方法 2015年7月～2019年5月我院肝胆外科收治的胆囊结石患者248例,采用随机数字表法分为对照组124例和观察组124例。在行腹腔镜下胆囊切除术时,观察组在麻醉诱导插管前10 min给予右美托咪定静脉滴注,再以0.25 μg·kg-1·h-1静脉滴注至手术完毕。在麻醉诱导期间,给予芬太尼、咪达唑仑和丙泊酚静脉滴注,在麻醉维持期间持续给予丙泊酚和瑞芬太尼,至手术结束;对照组在麻醉诱导前给予生理盐水静脉滴注,以后除不应用右美托咪定外,其他麻醉用药同观察组。采用疼痛数字等级评分量表(NRS)和Ramsay镇静评分量表进行镇痛和镇静效果评价,采用ELISA法检测血清超氧化物歧化酶(SOD)和丙二醛(MDA)水平,采用微量法检测血清总抗氧化能力(T-AOC)水平。结果 在术后2 h、6 h和12 h,观察组NRS动态评分分别为(2.5±0.7)分、(2.8±1.3)分和(2.6±1.0)分,显著低于对照组【分别为(3.1±0.6)分、(3.3±0.8)分和(3.9±0.9)分,P<0.05】,Ramsay镇静评分分别为(2.7±0.8)分、(2.7±1.0)分和(2.9±1.0)分,显著高于对照组【分别为(1.5±0.6)分、(1.9±0.5)分和(2.1±0.4)分,P<0.05】;在术后5 h,观察组血清SOD水平为(90.4±10.5) U/mL,显著高于对照组【(82.6±9.8) U/mL,P<0.05】,血清T-AOC水平为(15.3±2.4) U/mL,显著高于对照组【(12.2±2.0) U/mL,P<0.05】,而血清MDA水平为(3.2±0.6) mmol/mL,显著低于对照组【(4.5±0.8) mmol/mL,P<0.05】; 观察组苏醒后恶心、呕吐和头晕等不良反应发生率为3例(2.4%),而对照组为2例(1.6%,P>0.05),无显著性差异。结论 应用右美托咪定联合丙泊酚麻醉能显著提高腹腔镜胆囊切除术患者围手术期镇痛和镇静效果,降低患者术后氧化应激反应。
|
| 关 键 词： | 胆囊结石 胆囊切除术 右美托咪定 丙泊酚 麻醉 氧化应激反应 |
Efficacy of dexmedetomidine and propofol analgesia and sedation in patients with cholecystolithiasis undergoing laparoscopic cholecystectomy |
| |
| Chen Xianyu,He Chuan. Efficacy of dexmedetomidine and propofol analgesia and sedation in patients with cholecystolithiasis undergoing laparoscopic cholecystectomy[J]. Journal of Clinical Hepatology, 2020, 23(3): 443-446. DOI: 10.3969/j.issn.1672-5069.2020.03.035 |
| |
| Authors: | Chen Xianyu He Chuan |
| |
| Affiliation: | Department of Anesthesiology, Provincial Central Forestry Hospital, Chengdu 610000, Sichuan Province, China |
| |
| Abstract: | Objective The aim of this study was to analyze the analgesic and sedative effects of dexmedetomidine and propofol combination in patients undergoing laparoscopic cholecystectomy(LC).Methods 248 patients with holecystolithiasis were admitted to the Department of Hepatobiliary Surgery in our hospital between July 2015 and May 2019,and were randomly divided into control and observation group,124 cases in each.All the patients underwent LC,and the patients in observation group were given intravenous infusion of dexmedetomidine at 0.5 g.kg-110 minutes before the anesthesia induction intubation,followed by intravenous infusion of it at 0.25 g.kg-1·h-1 until the operation was completed.The patients in control group were intravenously given normal saline before the induction of anesthesia,and the other anesthetic drugs were the same except dexmedetomidine.The analgesia and sedation were evaluated by numerical rating scale(NRS)and Ramsay scale.Serum dismutase(SOD)and malonicdialdehyde(MDA)were detected by ELISA,and serum total superoxide antioxidant capacity(T-AOC)was also obtained.Results At two,six and twelve hours,the NRS score in the observation group were(2.5±0.7),(2.8±1.3)and(2.6±1.0),significantly lower than【(3.1±0.6),(3.3±0.8)and(3.9±0.9),respectively,P<0.05】in the control,and Ramsay scale score were(2.7±0.8),(2.7±1.0)and(2.9±1.0),significantly higher than【(1.5±0.6),(1.9±0.5)and(2.1±0.4),respectively,P<0.05】;at five hour post-operation,serum SOD level in the observation group was(90.4±10.5)U/mL,significantly higher than【(82.6±9.8)U/mL,P<0.05】in the control,serum T-AOC was(15.3±2.4)U/mL,much higher than【(12.2±2.0)U/mL,P<0.05】in the control,while serum MDA level was(3.2±0.6)mmol/mL,significantly lower than【(4.5±0.8)mmol/mL,P<0.05】in the control;the incidence of adverse reactions such as nausea,vomiting and dizziness was not significantly different between the two groups(2.4%vs.1.6%,P>0.05).Conclusion The application of dexmedetomidine and propofol combination for anesthesia in patients with cholecystolithiasis undergoing LC is efficacious for improving the perioperative analgesia and sedation,which might be related to the inhibition of oxidative stress and is worthy of clinical verification. |
| |
| Keywords: | Cholecystolithiasis Dexmedetomidine Propofol Laparoscopic cholecystectomy Anesthesia Oxidative stress |
| 本文献已被 CNKI 维普 等数据库收录！ |
| 点击此处可从《实用肝脏病杂志》浏览原始摘要信息 |
|
点击此处可从《实用肝脏病杂志》下载免费的PDF全文 |
|
