右美托咪定联合七氟烷吸入在宫腔镜电切术中的麻醉效果研究

Combination of Dexmedetomidine and Sevoflurane for hysteroscopic resection

目的监测并分析右美托咪定联合七氟烷吸入对宫腔镜电切术的麻醉效果。方法选取2014年1月-2015年12该院进行宫腔镜电切术治疗的患者72例为研究对象,根据麻醉方式不同将所有72例患者回顾性分为研究组与对照组,研究组患者采用右美托咪定静脉泵注联合七氟烷吸入麻醉,对照组患者单纯采用七氟烷吸入麻醉,观察并统计各项临床指标及不良反应。结果研究组患者T2心率(HR)、T2呼吸率(RR)、T3 HR和T4 HR与对照组相比较差异有统计学意义(P<0.05),研究组患者T2收缩压(SBP)、T2舒张压(DBP)、T2 RR、T3 HR和T4 HR与T1相比较差异有统计学意义(P<0.05),研究组患者麻醉起效时间较对照组稍短,意识恢复时间稍长,但两组患者麻醉起效及意识恢复时间相比较差异无统计学意义(P>0.05),研究组患者术中呼吸抑制、镇静效果Ramsay镇静评分、清醒程度警觉/镇静观察评分法(OAA/S)、数字疼痛评分法(NPRS)术后宫缩痛评分优良情况、术后恶心和呕吐情况与对照组相比较差异有统计学意义(P<0.05)。结论右美托咪定静脉泵注联合七氟烷吸入对采取宫腔镜电切术患者具有良好的临床麻醉效果。

Objective To observe the clinical effects of Dexmedetomidine in combination with Sevofurane for hysteroscopic resection. Methods 72 patients underwent hysteroscopic resection from January 2014 to December 2015 were divided into study group and control group according to the anesthesia mode. Patients in study group were in combination anesthesia mode of intravenous infusion of Dexmedetomidine and Sevoflurane inhalation, while patients in control group received Sevofurane inhalation only. The clinical parameters and adverse reactions were observed and studied. Results Compared with control group, signifcant differences were shown in patients heart rate at T2, T3 and T4 and breathing rate at T2 in observation group （P 〈 0.05）. Compared with T1 phase, there was statistical signifcance in study group patients systolic blood pressure （SBP）, diastolic blood pressure （DBP）, RR at T2, HR at T3, T4 （P 〈 0.05）; Compared with control group, patients in study group had short onset time of anesthesia and long recovery of consciousness, while there has no statistical significance of the two groups （P 〉 0.05）. Compared with control group, the respiratory depression, sedative effect of Ramsay sedation score, wakefulness, alertness / sedation score of observation method （OAA/S）, digital pain score （NPRS）, postoperative uterine contraction pain score, postoperative nausea and vomiting of study group had signifcant statistical differences （P 〈 0.05）. Conclusion Combination anesthesia mode of intravenous pumping Dexmedetomidine and inhalation of Sevofurane has good clinical effects for patients undergoing hysteroscopic resection.