右美托咪定鼻腔给药辅助全身麻醉对鼻内镜手术患者血流动力学及应激指标的影响
Effects of Dexmedetomidine Nasal Administration Assisted General Anesthesia on Hemodynamics and Stress Indexes in Patients Undergoing Nasal Endoscopic Surgery
张爱林 1龙师琼 1张玲 1晏宇2
作者信息
- 1. 萍乡矿业集团有限责任公司总医院麻醉科 江西 萍乡 337000
- 2. 萍乡矿业集团有限责任公司总医院手术室 江西 萍乡 337000
- 折叠
摘要
目的:探讨右美托咪定(Dex)鼻腔给药辅助全身麻醉对鼻内镜手术患者血流动力学及应激指标的影响.方法:选取 2020 年 3 月—2022 年 8 月萍乡矿业集团有限责任公司总医院收治的 80 例鼻内镜手术患者,根据随机数字表法分为对照组、观察组,各 40 例.对照组予以生理盐水鼻腔给药辅助全身麻醉下手术,观察组予以Dex鼻腔给药辅助全身麻醉下手术.于给药前(T0)、给药后 30 min(T1)、术毕(T2)、拔管时(T3),比较两组血流动力学[心率(HR)、平均动脉压(MAP)];于术前、术后,比较两组应激反应[血清皮质醇(Cor)、去甲肾上腺素(NE)].结果:整体分析结果显示,MAP、HR时间、组间、交互作用比较,差异均有统计学意义(P＜0.05).进一步组内两两比较显示,两组T0 时的血流动力学指标比较,差异均无统计学意义(P＞0.05);T1、T2、T3 时,对照组MAP、HR均高于T0 时,观察组均低于对照组,差异均有统计学意义(P＜0.05);观察组T1、T2、T3 时MAP、HR与T0 时比较,差异均无统计学意义(P＞0.05).拔管后,两组血清Cor、NE水平均显著升高,但观察组均低于对照组,差异均有统计学意义(P＜0.05).结论:Dex鼻腔给药辅助全身麻醉能够维持鼻内镜手术患者血流动力学稳定,减轻机体应激反应,具有一定应用价值.
Abstract
Objective:To investigate the effects of Dexmedetomidine(Dex)nasal administration assisted general anesthesia on hemodynamics and stress indexes in patients undergoing endoscopic nasal surgery.Method:A total of 80 patients with nasal endoscopic surgery admitted to the General Hospital of Pingxiang Mining Group Co.,LTD.from March 2020 to August 2022 were selected and divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was given normal saline nasal administration assisted general anesthesia,and the observation group was given Dex nasal administration assisted general anesthesia.The hemodynamics[heart rate(HR),mean arterial pressure(MAP)]were compared between the two groups before administration(T0),30 min after administration(T1),the end of operation(T2)and the time of extubation(T3).Before and after operation,stress response[serum cortisol(Cor),norepinephrine(NE)]was compared between the two groups.Result:The results of overall analysis showed that there were statistically significant differences in the MAP and HR time,inter-group and interaction(P＜0.05).Further pairwise comparison within the group showed that there were no statistically significant differences in hemodynamic indexes at T0 between the two groups(P＞0.05).At T1,T2 and T3,MAP and HR of the control group were higher than those at T0,those of the observation group were lower than those of the control group,the differences were statistically significant(P＜0.05);there were no statistically significant differences in MAP and HR between T1,T2,T3 and T0 in the observation group(P＞0.05).After extubation,the serum Cor and NE levels of the two groups were significantly increased,but those in the observation group were lower than those in the control group,with statistical differences(P＜0.05).Conclusion:Dex nasal administration assisted general anesthesia can maintain hemodynamic stability and reduce the stress response of patients undergoing nasal endoscopic surgery,which has certain application value.
关键词
鼻内镜手术/全身麻醉/右美托咪定/鼻腔给药/血流动力学/应激指标Key words
Nasal endoscopic surgery/General anesthesia/Dexmedetomidine/Nasal administration/Hemodynamics/Stress index引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据