沈阳医学院学报2024，Vol.26Issue(3)：261-266,6.DOI:10.16753/j.cnki.1008-2344.2024.03.007
右美托咪定联合艾司氯胺酮麻醉在冠心病非心脏手术中效果研究
Effect of dexmedetomidine combined with esketamine anesthesia in non-cardiac surgery for coronary artery disease
摘要
Abstract
Objective:To analyze the effect of dexmedetomidine combined with esketamine anesthesia on non-cardiac surgery for coronary heart disease and the effect on hemodynamics,stress response and postoperative complications of patients.Method:A total of 106 patients with coronary heart disease who were going to undergo laparoscopic abdominal surgery from Oct 2021 to Nov 2022 in our hospital were selected and randomly divided into the control group and the observation group,with 53 cases in each group.All patients underwent conventional surgical treatment.The control group was given dexmedetomidine anesthesia,while the observation group was given dexmedetomidine combined with esketamine anesthesia.The surgical indicators,incidence of postoperative complications,diastolic blood pressure(DBP),systolic blood pressure(SBP),pain visual analog scale(VAS),Ramsay sedation score,and the levels of oxide dismutase(SOD),malondialdehyde(MDA),cortisol(Cor)and blood glucose(GLU)were compared between the two groups.Results:There was no statistically significant difference in the operation time between the two groups(P＞0.05),but the postoperative sufentanil dosage of the observation group was lower than that of the control group,and the number of effective compressions was higher than that of the control group(P＜0.05).At 12 h postoperatively,there was no significant difference between the VAS score and Ramsay sedation score of the two groups(P＞0.05),and the VAS score and Ramsay sedation score in the observation group were better than those in the control group at 4 h and 8 h postoperatively(P＜0.05).The levels of MDA,GLU and Cor in both groups increased and the level of SOD decreased at 4 h postoperatively(P＜0.05),and the level of SOD in the observation group was higher than that of the control group,and the levels of MDA,GLU and Cor were lower than those of the control group(P＜0.05).Before anesthesia,there was no statisti-cally significant difference in hemodynamic indexes between the two groups(P＞0.05).Compared with before anesthesia,there were changes in HR,SBP,DBP,and RR of the two groups at the end of the operation and 24 h after the operation(P＜0.05),and the HR,SBP,DBP,and RR of the observation group were better than those of the control group(P＜0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P＜0.05).Conclusion:Dexmedetomidine combined with esketamine anesthesia can effectively stabilize the hemodynamics of patients,reduce postoperative stress response,and reduce postoperative complications.关键词
右美托咪定/艾司氯胺酮/冠心病/血流动力学/应激反应/并发症Key words
dexmedetomidine/esketamine/coronary heart disease/hemodynamics/stress response/complications分类
医药卫生引用本文复制引用
汪东升,张从利,张阳,庄芹,李晓红..右美托咪定联合艾司氯胺酮麻醉在冠心病非心脏手术中效果研究[J].沈阳医学院学报,2024,26(3):261-266,6.基金项目
安徽省卫生健康科研项目(No.AHWJ2022b024) （No.AHWJ2022b024）
