Protective Effects of Dexmedetomidine Combined with Sufentanil on Cerebral Oxygen Metabolism and Liver Function in Elderly Patients During Recovery from General Anesthesia

XIAO Guofeng; LYU Hao

doi:10.14009/j.issn.1672-2124.2022.09.005

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Protective Effects of Dexmedetomidine Combined with Sufentanil on Cerebral Oxygen Metabolism and Liver Function in Elderly Patients During Recovery from General Anesthesia

更新时间：2023-04-16

- Protective Effects of Dexmedetomidine Combined with Sufentanil on Cerebral Oxygen Metabolism and Liver Function in Elderly Patients During Recovery from General Anesthesia
- Vol. 22, Issue 9, Pages: 1046-1049(2022)
- 作者机构：
  
  中国人民解放军总医院第六医学中心麻醉科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2022.09.005
  CLC： R614.2
- Published：2022，
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XIAO Guofeng, LYU Hao. Protective Effects of Dexmedetomidine Combined with Sufentanil on Cerebral Oxygen Metabolism and Liver Function in Elderly Patients During Recovery from General Anesthesia. [J]. 22(9):1046-1049(2022)
DOI：

XIAO Guofeng, LYU Hao. Protective Effects of Dexmedetomidine Combined with Sufentanil on Cerebral Oxygen Metabolism and Liver Function in Elderly Patients During Recovery from General Anesthesia. [J]. 22(9):1046-1049(2022) DOI： 10.14009/j.issn.1672-2124.2022.09.005.

摘要

目的：探讨右美托咪定复合舒芬太尼对老年患者全身麻醉苏醒期脑氧代谢和肝脏功能的保护作用。方法：将2020年1月至2021年1月于该院接受外科手术的90例患者作为研究对象，按随机数字表法分为A组(n=30)、B组(n=30)和C组(n=30)。A组患者采用右美托咪定复合舒芬太尼持续泵入维持麻醉，B组患者单纯使用舒芬太尼，C组患者使用0.9%氯化钠注射液。比较三组患者的躁动发生率和不同时间的疼痛视觉模拟评分(VAS);记录手术前后心率(HR)、平均动脉压(MAP)水平；记录麻醉诱导前(T

)、手术终止时(T

)和术后24 h(T

)的脑氧代谢情况[颈静脉球血氧饱和度(SjvO

)、脑氧摄取率(CERO

)];检测三组患者T

、切皮时(T

)、气管插管后5 min(T

)、T

和T

时的丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平。结果：三组患者术前、术后1 h和术后2 h的MAP、HR水平均先升高后降低；三组患者MAP、HR水平在术后1 h、2 h时组间比较的差异均有统计学意义(P

0.05)。A、B和C组患者躁动发生率分别为3.33%(1例)、6.67%(2例)和26.67%(8例)

三组间两两比较，差异均有统计学意义(P

0.05)。三组患者组内术前、术后1 h和术后2 h的VAS评分比较，差异有统计学意义(P

0.05)

且均先降低后升高；三组患者术后1 h、术后2 h的VAS评分组间比较，差异有统计学意义(P

0.05)。三组患者T

和T

时的SjvO

、CERO

水平组间比较，差异有统计学意义(P

0.05)。T

—T

时，三组患者ALT、AST水平组间比较，差异有统计学意义(P

0.05)。结论：右美托咪定复合舒芬太尼可减少老年手术患者全身麻醉苏醒期的心血管应激及躁动反应，在一定程度上减轻患者的疼痛，改善脑氧代谢，缓解脑损伤，有效抑制肝损伤，保护患者的残余肝功能。

Abstract

OBJECTIVE: To probe into the protective effects of dexmedetomidine combined with sufentanil on cerebral oxygen metabolism and liver function in elderly patients during recovery from general anesthesia. METHODS: A total of 90 patients undergoing surgery in the hospital from Jan. 2020 to Jan. 2021 were selected as the research objects. The patients were divided into the group A（n=30）

group B（n=30） and group C（n=30） according to the random number table method. Patients in group A were treated with dexmedetomidine combined with sufentanil by continuous pumping to maintain anesthesia

the group B were given sufentanil alone

and the group C received 0.9% sodium chloride injection. The incidence of agitation and visual analogue scale（VAS） at different time points were compared among three groups. The heart rate（HR） and mean arterial pressure（MAP） levels before and after surgery were recorded; the cerebral oxygen metabolism [suturation jugular venous blood（SjvO

）

cerebral oxygen extraction rate（CERO

）] was recorded before anesthesia induction（T

）

at the end of surgery（T

） and after surgery of 24 h（T

）. The levels of alanine aminotransferase（ALT） and aspartate aminotransferase（AST） at T

skin incision（T

）

5 min after tracheal intubation（T

）

and T

were detected in three groups. RESULTS: The MAP and HR levels of three groups before surgery

after surgery of 1 h and 2 h increased first and then decreased. There were significant differences in levels of MAP and HR among three groups after surgery of 1 h and 2 h（P

0.05）. The incidences of agitation in group A

B and C were respectively 3.33%（1 case）

6.67%（2 cases）and 26.67%（8 cases）

the difference was statistically significant（P

0.05）. There were statistically significant differences in VAS scores within three groups before surgery

after surgery of 1 h and 2 h（P

0.05）

which decreased first and then increased. There were significant differences in VAS scores among three groups after surgery of 1 h and 2 h（P

0.05）. There were statistically significant differences in SjvO

and CERO

among three groups at T

and T

（P

0.05）. From T

to T

there were significant differences in levels of ALT and AST among three groups（P

0.05）. CONCLUSIONS: Dexmedetomidine combined with sufentanil can reduce the cardiovascular stress and restlessness response of elderly patients during recovery from general anesthesia

and alleviate the pain of patients to a certain extent

improve the cerebral oxygen metabolism

alleviate the brain injury level

effectively inhibit the liver injury and protect the residual liver function of patients.

关键词

右美托咪定舒芬太尼老年患者全身麻醉苏醒期脑氧代谢残余肝功能

Keywords

DexmedetomidineSufentanilElderly patientsGeneral anesthesiaRecovery periodCerebral oxygen metabolismResidual liver function

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