论文部分内容阅读
目的:观察地佐辛复合右美托咪定用于高血压患者乳腺癌手术全麻诱导的临床效果。方法:选择我院择期行乳腺癌改良根治术的患者90例,随机分为Ⅰ、Ⅱ、Ⅲ组,n=30。Ⅰ组给予芬太尼2~5μg/kg,Ⅱ组给予地佐辛0.2~0.3 mg/kg,Ⅲ组持续输注右美托咪定1μg/(kg·h)10 min后给予地佐辛0.2~0.3 mg/kg,三组患者均常规行全麻诱导。记录围插管期的平均动脉压(MAP)、心率(HR),并测定T0、T1、T2、T3时血浆肾上腺素(E)和去甲肾上腺素(NE)的浓度,同时记录患者拔管即刻、拔管后1 min的MAP、HR及术中给予的心血管活性药物的总剂量等情况。结果:Ⅰ组患者MAP、HR在T1、T2、T5时刻的数值及围插管期血浆肾上腺素(E)和去甲肾上腺素(NE)浓度变化分别与其前一时点相比,差异有统计学意义(P<0.05)。Ⅱ、Ⅲ两组围插管期血浆肾上腺素(E)和去甲肾上腺素(NE)浓度虽然都有波动,但与前一时点比较差异均无统计学意义(P>0.05)。结论:地佐辛复合右美托咪定用于高血压患者乳腺癌手术全麻诱导不仅可以有效抑制气管插管应激反应,维持术中血流动力学稳定,降低患者术后对疼痛的敏感性,而且对患者术后意识、呼吸等恢复没有影响。
Objective: To observe the clinical effect of dezocine combined with dexmedetomidine in the induction of general anesthesia for breast cancer patients with hypertension. Methods: Ninety patients who underwent modified radical mastectomy in our hospital were randomly divided into groups Ⅰ, Ⅱ and Ⅲ, n = 30. Group Ⅰ was given fentanyl 2 ~ 5μg / kg, group Ⅱ was given dezocine 0.2 ~ 0.3 mg / kg, group Ⅲ was continued infusion of dexmedetomidine 1μg / (kg · h) for 10 min after giving dezocine 0.2 ~ 0.3 mg / kg, all three groups were routinely induced by general anesthesia. The mean arterial pressure (MAP) and heart rate (HR) during intubation were recorded. The concentrations of plasma epinephrine (E) and norepinephrine (NE) at T0, T1, T2 and T3 were recorded. Immediate, 1 min after extubation of MAP, HR and intraoperative administration of the total dose of cardiovascular active drugs and so on. Results: The values of MAP and HR at T1, T2, T5 and the changes of plasma concentrations of epinephrine (E) and norepinephrine (NE) during peri-intubated period in group Ⅰ were statistically different from those in the previous time point Significance (P <0.05). Although the concentrations of plasma epinephrine (E) and norepinephrine (NE) fluctuated during the period of peri-intubation, there was no significant difference between the two groups (P> 0.05). Conclusion: Dezocine combined with dexmedetomidine for hypertensive patients with breast cancer surgery can not only effectively induce general anesthesia tracheal intubation stress response, to maintain intraoperative hemodynamic stability and reduce postoperative pain sensitivity Sex, but also on the patient awareness of postoperative recovery has no effect.