文献类型：期刊文献

中文题名：右美托咪定对老年全髋关节置换全麻手术患者术后苏醒时间及炎症因子的影响

英文题名：Influence of dexmedetomidine on postoperative awake time and inflammatory factors in the elderly patients undergoing general anesthesia total hip arthroplasty

作者：冯秀玲[1];董良坤[1];畅艳娜[1]

第一作者：冯秀玲

机构：[1]甘肃中医药大学附属医院麻醉手术科,甘肃兰州730020

第一机构：甘肃中医药大学第二附属医院

年份：2020

卷号：46

期号：4

起止页码：10

中文期刊名：兰州大学学报：医学版

收录：CSTPCD

基金：甘肃省卫生行业科研计划项目(GSWSKY-2014-48)。

语种：中文

中文关键词：右美托咪定;老年全麻患者;苏醒时间;炎症因子

外文关键词：dexmedetomidine;elderly patient undergoing general anesthesia;awake time;inflammatory factor

摘要：目的探讨右美托咪定对老年全髋关节置换全麻手术患者术后苏醒时间及炎症因子的影响。方法选择甘肃中医药大学附属医院择期全麻下行全髋置换手术的老年患者120例,年龄65~85岁,ASA分级Ⅱ或Ⅲ级,随机分为右美托咪定组(A组)和正常对照组(B组),每组60例。观察并记录2组患者术中使用丙泊酚及瑞芬太尼用量,比较2组患者术前(T0)、插管前(T1)、插管后5 min(T2)、手术开始10 min(T3)、手术开始30 min(T4)、停药后10 min(T5)各时间节点血流动力学改变,及停药至呼吸恢复时间(T6)、停药至呼之睁眼时间(T7)、停药至拔管时间(T8)、停药至定向力恢复时间(T9)等术后苏醒时间。2组患者分别于术前1 d、术毕、术毕24 h、术毕72 h测定血浆中血肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平、C-反应蛋白(CRP)质量浓度。结果A组患者术中丙泊酚及瑞芬太尼用量较B组患者显著减少(P<0.05),且A组患者T6、T7、T8、T9均显著低于B组患者(P<0.05);A组患者术毕、术毕24 h、术毕72 h血浆TNF-α、IL-6、CRP质量浓度均低于B组患者,且差异有统计学意义(P<0.05)。结论右美托咪定能够维持术中血流动力学稳定,降低术后炎症因子的表达,提高老年患者的术后恢复质量。
Objective To investigate the influence of dexmedetomidine on the postoperative awake time and inflammatory factors in the elderly patients undergoing general anesthesia total hip arthroplasty.Methods One hundred and twenty old patient,ASA Ⅱ or Ⅲ,scheduled to undergo total hip arthroplasty,from Affiliated Hospital of Gansu University of Chinese Medicine,were randomly divided into a dexmedetomidine group(group A)and the control group(group B).The plasma concentrations of propofol and remifentanil were recorded during the maintaining period.Hemodynamic changes at each time node before surgery(T0),before intubation(T1),5 min after intubation(T2),10 min after surgery(T3),30 min after surgery(T4),and 10 min after drug withdrawal(T5)were compared between the two groups.Also compared were the breathing recovery time(T6),awakening time(T7),time of orientatious recovery(T8),recovery time of instruction reaction(T9),and the concentration of plasma TNF-α,IL-6,CRP preoperative day,end of operation,24 and 72 hours after the operation.Results Compared with group B,the plasma concentrations of propofol and remifentanil during the maintaining period decreased in group A(P<0.05),T6,T7,T8,T9 shortened(P<0.05),TNF-α,IL-6 and CRP levels shortened at end of operation,24 and 72 hours after operation(P<0.05).There was no difference in the concentration of plasma TNF-α,IL-6 and CRP on the preoperative day.Conclusion Dexmedetomidine can improve the quality of postoperative recovery through shortening the awaking time and anti-inflammatory action,and maintaining intraoperative hemodynamic stability.