小剂量右美托咪定对宫颈癌微创手术患者恶心呕吐影响的研究

Study on effect of low dose of dexmedetomidine on nausea and vomiting in patients with cervical cancer minimally invasive surgery

目的探究小剂量右美托咪定对宫颈癌微创手术患者恶心呕吐的影响。方法选取2014年6月至2016年6月海南省中医院收治的122例宫颈癌微创手术患者为研究对象,将患者采用随机数表法分为对照组和观察组,各61例。麻醉诱导前观察组患者经1min静脉注射0.1μg/kg右美托咪定,对照组患者给予等量生理盐水。对比两组患者围术期各项指标、恶心呕吐分级和不良反应发生情况。结果两组患者的麻醉时间、手术时间、睁眼时间、自主呼吸恢复时间、拔除气管导管时间比较,差异无统计学意义(P>0.05)。观察组患者术中心率(HR)最低值低于对照组患者,心动过缓发生率高于对照组患者,差异有统计学意义(P<0.05)。T2时刻(术后1.0h)观察组患者恶心呕吐分级(PONV)Ⅱ级构成比显著低于对照组T2时刻PONVⅡ级构成比,T4时刻(术后24.0h)观察组患者恶心呕吐发生率显著低于对照组,差异有统计学意义(P<0.05)。对照组患者的躁动发生率高于观察组,差异有统计学意义(P<0.05)。结论小剂量右美托咪定能够显著缓解宫颈癌微创手术患者术后恶心呕吐,并能够降低躁动发生率,且不会影响麻醉效果,但容易发生心动过缓。

Objective To explore the effect of small dose of dexmedetomidine on nausea and vomiting in the patients with cervical cancer minimally invasive surgery.Methods One hundred and twenty-two cases of cervical cancer minimally invasive surgery in the hospital from June 2014 to June 2016 were selected as the research subjects and divided into the control group and observation group according to the random number table method,61 cases in each group.The observation was intravenously injected by0.1μg/k dexmedetomidine for 1 min before anesthesia induction,while the control group was given the same volume of normal saline.The perioperative indexes,nausea and vomiting grade and adverse reactions occurrwence were comparfed between the two groups.The anesthesia time,operative time,eye opening time,autonomous respiratory recovery time and tracheal tube extubation time had no statistical differences between the two groups were compared.Results The intraoperative HR minimum value in the observation group was lower than that in the control group,the bradycardia occurrence rate was higher than that in the control group,the difference was statistically significant（P〈0.05）.The constituent ratio of PONV gradeⅡat T2 time point in the observation group was significantly lower than that in the control group,and the occurrence rate of nausea and vomiting at T4（postoperative 24 h）in the observation group was significantly lower than that in the control group,the difference was statistically significant（P〈0.05）.The occurrence rate of agitation in the control group was higher than that in the observation group,and the difference was statistically significant（P〈0.05）.Conclusion Small dose of dexmedetomidine can significantly alleviate postoperative nausea and vomiting in the patients with cervical cancer minimally invasive surgery,moreover can decrease the agitation occurrence rate without affecting the effect of anesthesia,but is prone to develop bradycardia.