右美托咪啶在老年直肠癌患者根治术全麻诱导前的应用研究.pdf

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1、中国肛肠病杂志2O13年第33卷第1O期2l右美托咪啶在老年直肠癌患者根治术全麻诱导前的应用研究宋希斌姜万维李成刚大连大学附属新华医院麻醉科(辽宁大连116021)摘要为探讨老年直肠癌患者根治术全麻诱导前应用右美托咪啶(DEX)的效果，将2011年7～9月于全麻下行直肠癌根治术的6O例老年患者随机分为观察组和对照组，每组3o例。观察组于麻醉诱导前静脉泵注DEX0．4g／kg，对照组静脉泵注等量生理盐水，对比两组患者静脉泵注DEX或生理盐水前(T。)、全麻诱导前(T)、气管插管后lmin(T。)及手术结束时(T。)的平均动脉压(MAP)和心率(HR)，以及术中丙

2、泊酚、苯磺顺阿曲库铵用量及七氟烷浓度。结果显示，、时两组MAP和HR比较差异均无统计学意义，P>O．05；T、Tz时观察组MAP和HR均比对照组低，Pd0．05。观察组术中丙泊酚用量、七氟烷浓度明显小于对照组，Pd0．05。结果表明，老年患者行直肠癌根治术全麻诱导前静脉泵注DEX可减少麻醉药用量，降低麻醉药使用浓度，提高患者麻醉的安全性。关键词右美托咪啶；直肠癌；全身麻醉；老年人；麻醉药用量ApplicationofDexmedetomidinebeforeSystemicAnesthesiaInductionforRadicalSurgeryofSenile

3、RectalCarcinomaPatientsSONGXi—bin。JIANGWan—wei，LCheng—gangDept．ofAnesthesia，XinhuaHospitalAffiliatedtoDalianUniversity，Dalian，Liaoning116021AbstractThisstudywastoinvestigatetheefficacyofDexmedetomidine(DEX)usedbeforesystemican—esthesiainductionforradicalsurgeryofsenilerectalcarcinom

4、apatients．The60senilepatientstobesubjec—tedtoradicalsurgeryfortheirrectalcarcinomafromJulytoSept．，2011yr．wererandomlydividedintoobservationgroupandcontrolgroup，30casesforeachone；beforeinductionobservationgroupreceivedin—jectionofDEXat0．4pg／kg，whilecontrolgroupatsamevolumeofnormalsal

5、inebyvenous—pump，thefot—lowingitemsweredetectedandobservedsuchasMAP(meanarterypressure)andHR(heartrate)atT．(beforeinjectionbyvenous—pump)，T1(beforeinduction)，T2(1minaftertrachealcatheterization)andT(attheendofoperation)，aswellasintraoperativedosageofpropofolandcis—atracurium．andthec

6、oncen—trationofsevoflurane．Asresults，inMAPandHRatTnandT1therewasnostatistica1differencesbetweenbothgroups(P>O．05)，butatT1andT2observationgroupwerealllowerthancontrolgroup(Pd0．05)：inthedosageofpropofolandsevofluraneconcentrationobservationgroupwasallsignificantlylessthancontrolgroup(

7、Pd0．05)．Resultsshowthatforradicalsurgeryofsenilerectalcarcinomapatientsbeforesystemicanesthesiainductionbyvenous—pumpinjectingDEXcanreducethedosageofanesthetics，decreaseusingconcentrationofanesthetics，SOthatenhancethepatientSsafety．KeyWordsDexmedetomidine；Recta1carcinoma；Systemicane

8、sthesia；Senile；Dosa