右美托咪定用于妇科腹腔镜手术的临床观察

Clinical observation on the effect of dexmedetomidine on patients undergoing gynecological laparoscopy

目的观察右美托咪定在妇科腹腔镜手术中的镇静效果及安全性。方法 ASAⅠ或Ⅱ级择期行妇科腹腔镜手术患者60例,随机分为右美托咪定组(D组)和生理盐水对照组(C组)。D组和C组于气管插管后手术开始前10 min分别静脉泵注右美托咪定0.5μg/kg和生理盐水。观察记录两组患者麻醉前、切皮、拔管时和术后1 h的血压、心率、脑电双频指数(BIS)以及拔除气管导管的时间。结果与麻醉前比较切皮时和拔管时C组血压明显升高和心率明显增快(P<0.05),D组血压、心率无明显变化。切皮时D组BIS明显低于C组(P<0.05)。D组的拔管时间与C组相比无明显延长(P>0.05)。D组术后烦躁的发生率显著低于C组(P<0.05)。结论右美托咪定可使妇科腹腔镜手术患者的血流动力学更稳定,且不影响术毕苏醒时间。

Objective To investigate the sedative effects and safety of dexmedetomidine in patients undergoing gynecological laparoscopy.Methods Sixty patients of ASA gradeⅠor Ⅱ,scheduled for gynecological laparoscopy,were randomly assigned into two groups： group D（n=30）,and group C（n=30）.Group D and group C received 0.5 μg/kg dexmedetomidine and normal saline,respectively,ten minutes before the operation through intravenous infusion.The blood pressure,heart rate（HR）,bispectral index（BIS） and the time of extubation were recorded before anesthesia,skin incision,extubation and an hour after operation.Results Compared with before anesthesia,the blood pressure and heart rate of group C at the time of skin incision and extubation increased significantly（P〈0.05）,while that of group D showed no significant difference.At the time of skin incision,BIS scores were significantly lower in group D than group C（P〈0.05）.The time of extubation in group D was not significantly longer than that in group C（P〈0.05）.The incidence of postoperative restlessness in group D was significantly lower（P〉0.05）.Conclusion Dexmedetomidine can make patients＇ hemodynamics more stable,with the recovery time not prolonged significantly.