■右美托咪定(Dex)是一种有效且高度选择性的α2-肾上腺素能受体激动剂。在适当的剂量范围内,Dex能有效减弱手术应激反应,提供术中血流动力学稳定性,提高患者康复质量。大剂量Dex可以延迟患者从麻醉中苏醒并增加心动过缓的发生率。这项随机对照试验旨在研究低剂量静脉Dex术前用药对腹腔镜胆囊切除术(LC)患者的影响。
■总共,100例接受LC的患者被随机分为C组(含生理盐水的术前用药)和D组(含0.5μg/kgDex的术前用药)。患者预先用生理盐水或Dex治疗,根据群体的不同,麻醉诱导前。在此之后,进行麻醉诱导和气管插管,手术期间维持麻醉。手术完成后,患者被转移到麻醉后监护病房(PACU),并停留在PACU,直至符合PACU出院标准.血液动力学参数,消耗麻醉药,手术时间,术后苏醒时间,拔管时间,术后疼痛,并记录并发症。
■两组患者术前心率(HR)、平均动脉压(MAP)比较差异无统计学意义(P>0.05)。D组气管插管后即刻和拔管后即刻的MAP和HR均显著低于C组(均P<0.05)。D组心动过缓发生率明显高于C组(P<0.05),而两组均未使用阿托品。D组丙泊酚和瑞芬太尼用量明显低于C组(P<0.05)。D组术后苏醒、拔管时间明显短于C组(P<0.05)。术后疼痛和恶心发生率的视觉模拟评分,呕吐,D组咳嗽明显低于C组(均P<0.05)。
■我们的数据表明,在全身麻醉诱导前使用右美托咪定(0.5µg/kg)的术前用药可以有效减轻术中应激反应和术后疼痛,维持围手术期血流动力学稳定,并降低不良事件的发生率,这可能是一种有效和安全的麻醉方案,值得临床进一步应用。
UNASSIGNED: Dexmedetomidine (Dex) is a potent and highly selective α2-adrenergic receptor agonist. Within an appropriate dose range, Dex can effectively attenuate the surgical stress response, provide intraoperative hemodynamic stability, and improve the patient recovery quality. High-dose Dex can delay patient awakening from anesthesia and increase the incidence of bradycardia. This randomized controlled trial aimed to investigate the effects of low-dose intravenous Dex
premedication in patients undergoing laparoscopic cholecystectomy (LC).
UNASSIGNED: In total, 100 patients undergoing LC were equally randomized into Group C (
premedication with saline) and Group D (
premedication with 0.5 µg/kg Dex). The patients were premedicated with saline or Dex, depending on the group, before anesthesia induction. Following this, anesthesia induction and endotracheal intubation was performed, and anesthesia was maintained during surgery. Following the completion of the surgery, the patients were transferred the post-anesthesia care unit (PACU) and stayed there until they met the PACU discharge criteria. The hemodynamic parameters, consumption of anesthetics, surgical duration, postoperative awakening time, extubation time, postoperative pain, and complications were recorded.
UNASSIGNED: No significant differences were observed in the heart rate (HR) and mean arterial pressure (MAP) between the two groups before
premedication (P>0.05). The MAP and HR immediately after endotracheal intubation and immediately after extubation were significantly lower in Group D than in Group C (P<0.05 for both). The incidence of bradycardia was significantly higher in Group D than in Group C (P<0.05), while atropine was used in neither group. Propofol and remifentanil consumption was significantly lower in Group D than in Group C (P<0.05). The postoperative awakening and extubation times were significantly shorter in Group D than in Group C (P<0.05). The postoperative visual analog scale scores for pain and incidence of nausea, vomiting, and cough were significantly lower in Group D than in Group C (P<0.05 for all).
UNASSIGNED: Our data suggest that
premedication with dexmedetomidine (0.5 µg/kg) before general anesthesia induction can effectively attenuate intraoperative stress response and postoperative pain, maintain perioperative hemodynamic stability, and decrease the incidence of adverse events, which might be an effective and safe anesthetic protocol during LC worthy of further clinical application.