【摘要】：目的觀察不同劑量右美托咪定對腹腔鏡下胃腸手術(shù)老年患者圍術(shù)期應(yīng)激反應(yīng)的影響。方法擇期行腹腔鏡下胃腸手術(shù)老年患者80例,性別不限,年齡≥65歲,ASAⅠ或Ⅱ級。隨機(jī)分為四組,每組20例。所有患者均采用全憑靜脈麻醉。D1、D2組和D3組麻醉誘導(dǎo)前10min靜脈泵注右美托咪定0.5μg/kg,插管后分別靜脈泵注右美托咪定0.2、0.5、0.8μg·kg~(-1)·h~(-1)至術(shù)畢前30min;C組麻醉誘導(dǎo)前10min靜脈泵注7ml生理鹽水,插管后靜脈泵注生理鹽水10ml/h至術(shù)畢前30min。記錄術(shù)中麻醉藥物用量,記錄給藥前(T_0)、氣管插管后即刻(T_1)、氣腹后5min(T_2)、氣腹后60min(T_3)、拔管后即刻(T_4)和拔管后10min(T_5)的HR、SBP、DBP,分別于T_0、T_1、T_3、T_5時抽取橈動脈血,測定Glu、Cor、E和NE濃度。結(jié)果 D1組、D2組和D3組術(shù)中瑞芬太尼的用量明顯少于C組,且D2組和D3組明顯少于D1組(P0.05)。與T_0時比較,T_1~T_5時C組HR明顯增快(P0.05)。T_2~T_5時,D2組和D3組的HR明顯慢于C組和D1組,SBP明顯低于C組(P0.05);T_1時D2組和D3組Cor和NE濃度也明顯低于C組(P0.05)。T_3和T_5時,D2組和D3組Glu、Cor、E和NE濃度明顯低于C組,D2組和D3組Cor和NE濃度明顯低于D1組(P0.05)。結(jié)論與0.2和0.8μg·kg~(-1)·h~(-1)右美托咪定靜脈泵注維持比較,0.5μg·kg~(-1)·h~(-1)能更有效抑制腹腔鏡下胃腸手術(shù)老年患者圍術(shù)期應(yīng)激反應(yīng)。
[Abstract]:Objective to observe the effect of different doses of dexmetomidine on perioperative stress response in elderly patients undergoing laparoscopic gastrointestinal surgery. Methods 80 elderly patients undergoing laparoscopic gastrointestinal surgery were enrolled in this study. Their age was 鈮，

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