麻醉诱导前泵注右美托咪定对室性心律失常患者围术期左心室功能、血流动力学的影响

Effect of dexmedetomidine infusion before induction of anesthesia on perioperative left ventricular function and hemodynamics in patients with ventricular arrhythmia

摘要:

目的 探讨麻醉诱导前泵注右美托咪定对室性心律失常患者围术期左心室功能、血流动力学的影响。方法 选取2020年7月—2022年2月赣南医学院第一附属医院收治的120例室性心律失常患者，根据不同方法分为对照组和观察组，各60例。对照组采用常规麻醉诱导、维持及术后镇痛，观察组则在麻醉诱导前泵注右美托咪定。比较两组手术相关指标、血流动力学指标、室性心律失常不良事件发生率、左心室心功能、不良事件等。结果 观察组苏醒时间较对照组长（P <0.05）。两组患者术后机械通气时间、ICU时间、住院时间比较，差异无统计学意义（P >0.05）。两组患者不同时间点MAP、SBP、HR、室性心律失常不良事件发生数比较，经重复测量设计的方差分析，结果 ①不同时间点MAP、SBP、HR、室性心律失常不良事件发生数有差异（F =42.653、71.521、32.845和21.584，均P <0.05）；②两组患者MAP、SBP、HR、室性心律失常不良事件发生数有差异（F =31.568、67.152、33.685和19.635，均P <0.05）。③两组患者MAP、SBP、HR、室性心律失常不良事件发生数变化趋势有差异（F =100.365、312.652、98.563和142.512，均P <0.05）。两组患者不同时间点LVEF、LVFS、E/A比较，经重复测量设计的方差分析，结果 ①不同时间点LVEF、LVFS、E/A有差异（F =51.632、89.521和100.245，均P <0.05）。②两组患者LVEF、LVFS、E/A有差异（F =26.325、62.521和79.632，均P <0.05）。③两组患者LVEF、LVFS、E/A变化趋势有差异（F =263.512、415.321和492.321，均P <0.05）。结论 麻醉诱导前泵注右美托咪定有助于改善室性心律失常患者围术期左心室功能和血流动力学，避免围术期发生不良事件。

Abstract:

Objective To investigate the effect of dexmedetomidine infusion before induction of anesthesia on perioperative left ventricular function and hemodynamics in patients with ventricular arrhythmia.Methods A total of 120 patients with ventricular arrhythmia admitted to our hospital from July 2020 to February 2022 were selected and divided into control group (n = 60) and observation group (n = 60). The control group was given routine induction of anesthesia, maintenance of anesthesia and postoperative analgesia, while the observation group was additionally given dexmedetomidine before induction of anesthesia. The surgical-associated indices, hemodynamics indices, incidence of ventricular arrhythmia-related adverse events, and left ventricular function were compared between the two groups.Results The recovery time of the observation group was shorter than that of the control group (P < 0.05). There was no difference in the duration of postoperative mechanical ventilation, length of intensive care unit stay, or the length of hospital stay between the two groups (P > 0.05). The MAP, SBP, HR and the incidence of ventricular arrhythmia-related adverse events at distinct time points in the two group were compared via the repeated measures analysis of variance, and the results revealed that they were different among the time points (F =42.653, 71.521, 32.845 and 21.584, all P < 0.05) and between the groups (F = 31.568, 67.152, 33.685 and 19.635, all P < 0.05), and that the change trends of them were also different between the two groups (F = 100.365, 312.652, 98.563 and 142.512, all P < 0.05). The LVEF, LVFS and E/A at distinct time points in the two group were also compared via the repeated measures analysis of variance, and the results revealed that they were different among the time points (F =51.632, 89.521 and 100.245, all P < 0.05) and between the groups (F =26.325, 62.521 and 79.632, all P < 0.05), and that the change trends of them were different between the two groups as well (F =263.512, 415.321 and 492.321, all P < 0.05).Conclusions Dexmedetomidine infusion before the induction of anesthesia can improve perioperative left ventricular function and hemodynamics in patients with ventricular arrhythmias, and reduce the risk of perioperative adverse events.