右美托咪定联合七氟醚对老年腹腔镜胃肠肿瘤切除术患者应激反应和脑氧代谢的影响.

Objective: To observe the effects of dexmedetomidine combined with sevoflurane on cerebral oxygen metabolism and stress response in elderly patients undergoing laparoscopic gastrointestinal tumor resection. Methods: 100 elderly patients undergoing laparoscopic gastrointestinal tumor resection who were treated in our hospital from January 2020 to December 2020 were divided into control group （n=50, sevoflurane anesthesia） and study group （n=50, dexmedetomidine combined with sevoflurane anesthesia） by random number table method. Hemodynamics, stress response, cerebral oxygen metabolism, cognitive function and adverse reactions of two groups were observed. Results: 60 min （T1） to 30 min （T3） after operation, The heart rate （HR） of the two groups first decreased and then increased compared with the time point before induction of anesthesia （T0）, and the mean arterial pressure （MAP） first increased and then decreased （P<0.05）. HR at T1～T3 time points in the study group were lower than those in the control group （P<0.05）. The dopamine（DA）, epinephrine （AD） and norepinephrine （NE） levels in two groups at 3 d after operation were increased, but the study group was lower than the control group （P<0.05）. The difference of blood oxygen content （DajvO2） and cerebral oxygen uptake rate （CERO2） in both groups at 3d after operation decreased, but the study group was lower than the control group （P<0.05）. The scores of mini mental state examination scale （MMSE） in the study group at 6h, 1d and 3d after operation were higher than those in the control group （P<0.05）There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion: Sevoflurane combined with dexmedetomidine in elderly patients undergoing laparoscopic gastrointestinal tumor resection can effectively reduce the body’s stress response, reduce the damage of cognitive function, and maintain hemodynamic stability and cerebral oxygen metabolism. [ABSTRACT FROM AUTHOR]