右美托咪定联合瑞芬太尼应用于腹腔镜下阑尾切除术对镇痛效果和血流动力学影响.docVIP

右美托咪定联合瑞芬太尼应用于腹腔镜下阑尾切除术对镇痛效果和血流动力学影响 　　[摘要] 目的 探讨右美托咪定联合瑞芬太尼应用于腹腔镜下阑尾切除术对镇痛效果和血流动力学的影响。方法 选取2016年6月～2017年2月我院行腹腔镜下阑尾切除术患者90例随机分为干预组和常规组，干预组于术前10min静脉泵入右美托咪定0.8μg/kg，常规组给予同等剂量生理盐水泵入，两组患者均用瑞芬太尼、丙泊酚复合全凭静脉麻醉，比较两组患者术前（T0）、术后即刻（T1）、术后1d（T2）、术后3d（T3）及术后1周（T4）疼痛评分、平均动脉压（MAP）、心率（HR）、心脏指数（CI）、心搏指数（SI）水平及并发症发生情况。结果 T1、T2时间节点，干预组患者VAS评分、MAP、HR低于常规组， CI、SI水平高于常规组（P0.05）。干预组心动过速、躁动发生率低于常规组（P0.05）。结论 右美托咪定联合瑞芬太尼应用于腹腔镜下阑尾切除术可显著减轻患者疼痛，维持患者血流动力学稳定，降低相关并发症发生率。 　　[关键词] 右美托咪定；瑞芬太尼；腹腔镜；阑尾切除术；镇痛；血流动力学 　　[中图分类号] R614 [文献标识码] A [文章编号] 2095-0616（2017）12-93-03 　　Effects of dexmedetomidine combined with remifentanil on on analgesia and hemodynamics in laparoscopic appendectomy 　　ZHANG Yougao LI Meirong ZHANG Jing WANG Yonggang BU Hong LI Lingfang LU Fengwen LU Yanna 　　Department of Anesthesiology， Tanzhou Zhongshan Hospital， Zhongshan 528467， China 　　[Abstract] Objective To investigate the effects of dexmedetomidine combined with remifentanil on on analgesia and hemodynamics in laparoscopic appendectomy. Methods 90 patients， who were underwent laparoscopic appendectomy in hospital from June 2016 to February 2017，were selected and randomly divided into intervention group and routine group. Before the operation 10 minutes， the intervention group was given intravenous infusion of dexmedetomidine 0.8μg/kg， and the routine group was given the same dose of normal saline pump. Two groups were treated with remifentanil and propofol combined with total intravenous anesthesia. The pain score， mean arterial pressure（MAP）， heart rate（HR）， heart index（CI）， heart beat index（SI） and complications were compared between the two groups in preoperative（T0）， immediately after operation（T1）， after 1 day（T2）， postoperative 3d（T3） and postoperative 1 week（T4）. Results At T1 and T2， the scores of VAS， MAP and HR in the intervention group were lower than those in the conventional group， and the levels of CI and SI were higher than those of the conventional group（P0.05）. The incidences of tachycardia and restle