Application Effects of Different Doses of Dexmedetomidine Before Anesthesia Induction in Elderly Patients with Coronary Heart Disease Undergoing Non-cardiac Surgery
Objective To investigate the application effects of different doses of dexmedetomidine before anesthesia induction in elderly patients with coronary heart disease undergoing non-cardiac surgery.Methods A total of 200 elderly patients with coronary heart disease who underwent non-cardiac surgery in Anyang District Hospital from January 2018 to October 2022 were selected as the study subjects.They were divided into control group,D1 group,D2 group and D3 group by random number table method,with 50 patients in each group.D1 group,D2 group and D3 group were injected with 0.50,0.75 and 1.00 μg·kg-1 of dexmedetomidine at 10 min before anesthesia induction,respectively.The control group was injected with equal dose of normal saline.The four groups were compared in terms of intraoperative conditions and indicators related to myocardial injury and oxidative stress before anesthesia induction(T0),at the end of surgery(T1),24 h after surgery(T2)and 48 h after surgery(T3).The incidence of adverse events was statistically analyzed.Results There was no statistically difference in surgical time and recovery time among the four groups of patients(P＞0.05).The dosage of sufentanil in groups D1,D2,and D3 was lower than that in the control group,and the dosage in group D1 was lower than that in groups D2 and D3(P＜0.05).There was no statistically difference in the dosage of sufentanil between group D2 and group D3(P＞0.05).At T0,there was no statistically difference in the levels of serum troponin Ⅰ(cTnⅠ)and N-terminal pro-B-type natriuretic(NT-proBNP)among the four groups(P＞0.05).At T,,T2,and T3,the above serum indicators were all higher than at time T0(P＜0.05).At T1,T2,and T3,the serum indicators of D1 group,D2 group,and D3 group were all lower than those of the control group,and the serum indicators of D1 group were all lower than those of D2 group and D3 group(P＜0.05).There was no statistically difference in the above serum indicators between the D2 and D3 groups at each time point(P＞0.05).At T0,there was no statistically difference in the levels of serum malondialdehyde(MDA)and superoxide dismutase(SOD)among the four groups of patients(P＞0.05).MDA levels were higher at T,,T2,and T3 than at T0,while SOD levels were lower at T0(P＜0.05).At T1,T2,and T3,the MDA levels in groups D1,D2,and D3 were all lower than those in the control group,while the SOD levels were higher than those in the control group.Moreover,the serum indicators in group D1 were superior to those in groups D2 and D3(P＜0.05).There was no statistically difference in the above serum indicators between the D2 and D3 groups at each time point(P＞0.05).Conclusion Applying low-dose dexmedetomidine to elderly patients with coronary heart disease undergoing non-cardiac surgery before anesthesia induction can protect their myocardia and reduce oxidative stress response,with good safety.
万方数据
维普
