右美托咪定辅助全身麻醉在腹腔镜结直肠癌根治术中的应用价值

目的研究右美托咪定辅助全身麻醉在腹腔镜结直肠癌根治术中的应用价值。方法选取2018年12月至2019年6月于该院行腹腔镜结直肠癌根治术的96例患者为研究对象,按照随机数字表法分为观察组与对照组,每组各48例;观察组采用右美托咪定辅助全身麻醉方式,对照组将右美托咪定换为等量生理盐水;观察两组患者麻醉前(T1)、气管插管后即刻(T2)、气管拔除后即刻(T3)、拔管后10min(T4)血流动力学指标,围麻醉期各项指标,接受手术后炎症因子水平及不良反应发生状况。结果手术过程中,对照组患者T2、T3的心率(HR)、平均动脉血压(MAP)较T1明显上升,差异有统计学意义(P<0.05),而观察组患者各时刻的血流动力学指标比较,差异无统计学意义(P>0.05),且观察组T2、T3HR、MAP明显低于对照组,差异有统计学意义(P<0.05)。两组患者的血氧饱和度(SpO2)比较,差异无统计学意义(P>0.05)。两组患者呼吸恢复时间、睁眼时间、拔管时间比较,差异无统计学意义(P>0.05)。观察组患者苏醒后呛咳、躁动评分明显低于对照组,差异有统计学意义(P<0.05)。两组患者T2、T3、T4白细胞介素-6、肿瘤坏死因子-α与干扰素-γ水平较T1依次上升,差异有统计学意义(P<0.05),且观察组与对照组比较,差异有统计学意义(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论右美托咪定辅助全身麻醉在腹腔镜结直肠癌根治术中具有很好的应用价值,有助于维持血流动力学稳定,减少术后呛咳、躁动症状,减轻机体炎性反应,疗效明显,安全性高。

Application value of dexmedetomidine assisted with general anesthesia in laparoscopic colorectal radical cancer surgery

Objective To study the application of dexmedetomidine assisted with general anesthesia in laparoscopic colorectal radical cancer surgery.Methods A total of 96 patients who underwent laparoscopic colorectal radical cancer surgery in Xi′an International Medical Center from December 2018 to July 2019 were selected for this study and were divided into two groups according to the random number table method,48 cases in each group.Patients in observation group were treated with dexmedetomidine assisted with general anesthesia,and patients in control group were replaced dexmedetomidine with same amount of normal saline.The hemodynamic parameters before anesthesia(T1),immediately after tracheal intubation(T2),immediately after tracheal removal(T3)and at 10 min after extubation(T4),hemodynamic parameters and inflammatory factors and occurrence of adverse reactions were observed in the the two groups.Results During surgery,the heart rate(HR)and mean arterial blood pressure(MAP)in control group at T2 and T3 increased significantly compared with those at T1(P<0.05).There was no significant difference on the hemodynamic parameter in observation group at each time point(P>0.05).The HR and MAP in observation group at T2 and T3 were significantly lower than those in control group(P<0.05).There was no significant difference on the oxygen saturation(SpO2)between the two groups(P>0.05).There was no significant difference on respiratory recovery time,eye-opening time and extubation time between the two groups(P>0.05),and the scores of bucking and agitation after recovery in observation group were significantly lower than those in control group(P<0.05).At T2,T3,T4,the interleukin-6,tumor necrosis factor-αand interferon-γin the two groups increased in turn compared with those at T1(P<0.05),and there were significant differences between observation group and control group(P<0.05).There was no significant difference on the adverse reactions between the two groups(P>0.05).Conclusion Dexmedetomidine assisted with general anesthesia has good application value in laparoscopic colorectal radical cancer surgery,and it could help maintain hemodynamic stability,reduce postoperative bucking and agitation symptoms,and reduce the body′s inflammatory response,with high safety.