右美托咪定不同给药方式用于妇科腹腔镜手术中的麻醉效果比较

Anesthetic effect comparison of different administration method of Dexmedetomidine in gynecological laparoscopic surgery

目的比较右美托味定不同给药方式用于妇科腹腔镜手术中的麻醉效果。方法选取2013年11月~2016年11月在我院妇科接受腹腔镜手术治疗的患者138例作为研究对象,采用随机数字表法将其随机分为A、B、C组,每组46例。其中C组为对照组,A、B组分别给予右美托咪定单次静脉注射、右美托咪定持续静脉泵注。比较三组患者的麻醉效果、不良反应发生情况。结果 A、B组的HR在T_1~T_5时均显著低于C组,A组的MAP在T_1~T_5时明显低于C组,B组的MAP在T_1、T_3~T_5时明显低于C组,差异均有统计学意义(P<0.05);A、B组的心动过速、恶心呕吐不良发生率均显著低于C组(P<0.05),A组的心动过缓发生率明显低于B组(P<0.05)。结论在妇科腹腔镜手术实施麻醉诱导前采用单次静脉注射右美托咪定,能够减缓患者的血流动力学波动,减少恶心呕吐等不良反应,且不增高心动过缓发生率,有助于促进患者术后恢复。

Objective To compare the anesthetic effect of different administration method of Dexmedetomidine in gyne- cological laparoscopic surgery.Methods 138 patients given with gynecological laparoscopic surgery from November 2013 to November 2016 in our hospital were selected as the research object.The patients were divided into the three groups：group A,B and C according to random number table method,and there were 46 cases in each group.Group C was the control group, group A and B was given Dexmedetomidine single intravenous injection and Dexmedetomidine con- tinuous intravenous infusion respectively.The anesthetic effect and incidence of adverse reactions were compared among the three groups.Results HR of group A and group B were significantly lower than that of group C at T1-T5,and MAP of group A was significantly lower than that of group C at T1-Ts,while MAP of group B was significantly lower than that of group C at T1 and T3-T5,and the differences were statistically significant （P〈0.05）.The incidence of taehycardia,nau- sea and vomiting in group A and group B were significantly lower than those in group C （P〈0.05）,while the incidence of bradyeardia in group A was significantly lower than that in group B （P〈0.05）.Conclusion A single intravenous injection of Dexmedetomidine was performed before induction of anesthesia in gynecologic laparoscopic surgery can reduce the hemodynamic fluctuation,reduce nausea,vomiting and other adverse reactions,and not increase the incidence of brady- cardia,and help to promote postoperative recovery of patients.