摘要
目的探究右美托咪定对老年患者围术期心血管事件及血管活性药物使用的影响。方法选取行腹腔镜手术的老年患者186例,按随机数表法分为研究组及对照组,每组各93例。研究组麻醉诱导前静脉泵注0.5μg/kg右美托咪定,后0.2μg/(kg·h)持续泵注至术毕前0.5 h;对照组泵注等容量生理盐水。比较两组围术期心血管事件发生率、血管活性药物使用次数及心率变异性[每5 min平均R-R间期标准差(standard deviation of sequential five-minute R-R interval means,SDANN)、全部窦性R-R间期标准差(standard deviation of normal R-R intervals,SDNN)、相邻R-R间期差值均方根(rootmean square standard deviations of R-R intervals,RMSSD)]。结果研究组术中及术后1 d内心血管事件总发生率分别为15.05%和4.30%,低于对照组的31.18%及12.90%(P<0.05或P<0.01)。研究组去氧肾上腺素、乌拉地尔、阿托品及艾司洛尔等血管活性药物使用次数均少于对照组(P<0.01)。术后1 d,两组SDANN、SDNN、RMSSD水平均下降,但研究组高于对照组(P<0.05)。结论静脉泵注右美托咪定可减少老年患者围术期心血管事件的发生及血管活性药物的应用,利于稳定心血管功能。
Objective To investigate the effects of dexmedetomidine on perioperative cardiovascular events and uses of vasoactive drugs in elderly patients.Methods A total of 186 elderly patients who underwent laparoscopic surgery were selected and divided into research group and control group according by using the random number table method with 93 cases in each group.In the research group,0.5μg/kg dexmedetomidine was injected intravenously before anesthesia induction,and 0.2μg/(kg·h)was continuously pumped to 0.5 h before surgery.In the control group,same amount of normal saline was given.The prevalence of perioperative cardiovascular events,the number of time needed to use of vasoactive drugs,and heart rate variability[standard deviation of sequential five-minute R-R interval means(SDANN),standard deviation of normal R-R intervals(SDNN),rootmean square standard deviation of R-R intervals(RMSSD)]in the two groups were compared.Results The number of cardiovascular events in study group during and 1 day after surgery was 15.05%and 4.30%,which were lower than those of the control group(31.18%and 12.90%,P<0.05 or P<0.01).The frequency of use of vasoactive drugs(phenylephrine,urapidil,atropine and esmolol)in study group was less than that in the control group(P<0.01).At 1 day after operation,the levels of SDANN,SDNN and RMSSD decreased in both groups,but the study group was higher than the control group(P<0.05).Conclusion Intravenous pumping of dexmedetomidine can reduce the prevalence of perioperative cardiovascular events and the application of vasoactive drugs in elderly patients,which is conducive to stable cardiovascular function.
作者
柳金强
肖开玉
LIU Jin-qiang;XIAO Kai-yu(Department of anesthesiology,people's hospital of jianli county,hubei province,Jingzhou 433300,Hubei Province,China)
出处
《世界临床药物》
CAS
2020年第2期128-132,共5页
World Clinical Drug
关键词
老年患者
围术期
右美托咪定
心血管事件
血管活性药物
elderly patients
perioperative period
dexmedetomidine
cardiovascular events
vasoactive drugs
