达克罗宁胶浆联合右美托咪定对老年患者胸腔镜下肺叶切除术苏醒期躁动的影响

目的探讨对老年患者行胸腔镜下肺叶切除术使用达克罗宁胶浆联合右美托咪定对苏醒期躁动的影响。方法选取2017年2月-2020年2月在江西省人民医院行胸腔镜肺叶切除术年龄≥65岁的106例患者为研究对象,依据术前给药方案分为观察组和对照组,观察组给予达克罗宁胶浆联合右美托咪定(56例),对照组给予右美托咪定(50例)。观察指标包括围术期指标、镇静评分及血流动力学指标等。结果2组睁眼、苏醒与拔管时间及麻醉药物用量等指标比较差异无统计学意义(P>0.05)。观察组的Riker及Ramsay镇静评分均低于对照组(P<0.05),观察组的苏醒期躁动评分(SAS)低于对照组(P<0.05)。随着手术时间的推移,所有患者的MAP和HP逐渐增加,而观察组各时程平均动脉压(MAP)和心率(HP)均低于对照组(P<0.05)。结论在老年患者胸腔镜下肺叶切除术中应用右美托咪定联合达克罗宁胶浆,具有安全、高效、稳定的优势,在规避患者躁动发生风险、维持血流动力学的稳定性等方面疗效满意,可获得满意的手术效果。

The effect of dyclonine gel combined with dexmedetomidine on emergence agitation after thoracoscopic lobectomy in elderly patients

Objective To investigate the effect of dyclonine gel combined with dexmedetomidine on emergence agitation after thoracoscopic lobectomy in elderly patients.Methods A total of 106 patients≥65 years of age who underwent thoracoscopic lobectomy in People’s Hospital of Jiangxi Province from February 2017 to February 2020 were selected as the research subjects.According to the preoperative administration regimen,they were divided into observation group and control group.The observation group was given dyclonine gel combined with dexmedetomidine(56 cases),and the control group was given only dexmedetomidine(50 cases).The observation indexes included perioperative indexes,sedation score,hemodynamic indexes and etc.Results There were no significant differences in eye opening time,awakening time,extubation time and anesthetic dosage between the two groups(P>0.05).The Riker and Ramsay sedation scores of the observation group were significantly lower than those of the control group(P<0.05);the Awakening Agitation Score(SAS)of the observation group was significantly lower than that of the control group(P<0.05).With the passage of the operation time,the mean arterial pressure(MAP)and heart rate(HP)of all patients gradually increased,while the MAP and HP of the observation group at each time point were lower than those of the control group(P<0.05).Conclusion The application of dexmedetomidine combined with dyclonine gel during thoracoscopic lobectomy in elderly patients has the advantages of safety,efficiency and stability.It can reduce the patient’s restlessness during the recovery period and maintain the stability of hemodynamics.The curative effect is satisfactory,and satisfactory surgical results can be obtained.