右美托咪定对行宫颈癌根治术且合并高血压的患者围术期血压、心率及苏醒质量的影响

Effects of hemodynamics and recovery quality of Dexmedetomidine in the period of perioperative to patients with cervical cancer combined with hypertensive

目的分析右美托咪定对行宫颈癌根治术且合并高血压的患者围术期血压、心率及苏醒质量的影响。方法将本院2016年1月至2017年1月收治的97例行宫颈癌根治术且合并高血压的患者随机分为观察组(47例)和对照组(50例),观察组患者采用右美托咪定+丙泊酚+瑞芬太尼+罗库溴铵联合麻醉,对照组患者采用丙泊酚+瑞芬太尼+罗库溴铵麻醉。比较两组患者不同时间点的收缩压、舒张压及心率、手术时间、睁眼时间、拔管时间、视觉模拟评分法(visual analogue scale,VAS)评分以及手术医师的术中满意度。结果麻醉前,两组患者的收缩压、舒张压及心率比较均无显著差异(P>0.05);气管插管时、气腹起始、气腹后15分钟、气腹后30分钟,观察组患者的收缩压、舒张压及心率均显著低于对照组(P<0.05)。两组患者手术时间比较无显著差异(P>0.05),观察组患者睁眼时间和拔管时间均显著短于对照组(P<0.05),拔管后10分钟VAS评分显著低于对照组(P<0.05),手术医师术中总满意率显著高于对照组(P<0.05)。结论对于行宫颈癌根治术且合并高血压的患者,右美托咪定+丙泊酚+瑞芬太尼+罗库溴铵联合麻醉效果满意,稳定术中患者的血压和心率,有助于患者尽快苏醒,安全性较高。

Objective To analyze the effects of hemodynamics and recovery quality of Dexmedetomidine in the period of perioperative to patients with cervical cancer combined with hypertensive. Method From January 2016 to January 2017, 97 patients with cervical cancer combined with hypertension underwent radical hysterectomy were randomly divided into observation group（47 cases） and control group（50 cases）. Patients in observation group were anaesthetized with Dexmedetomidine ＋ Propofol ＋Remifentanil ＋ Rocuronium bromide, and patients in control group were anesthetized with Propofol ＋ Remifentanil ＋ Rocuronium bromide. The systolic blood pressure, diastolic blood pressure, heart rate, operation time, blinking time, extubated time, visual analogue scale（VAS） score and surgeons＇ degree of satisfaction were compared between the two groups at different time points. ResultBefore anesthesia, there were no significant difference in systolic blood pressure, diastolic pressure and heart rate between the two groups（P〈0.05）; after tracheal intubation, pneumoperitoneum started, 15 minutes after pneumoperitoneum and 30 minutes after pneumoperitoneum, the systolic blood pressure, diastolic pressure and heart rate of patients in observation group were significantly lower than those of control group（P〈0.05）. There was no significant difference in the operation time between the two groups（P〈0.05）. The blinking time and extubated time of observation group were significantly shorter than that of control group（P〈0.05）, and the VAS score was significantly lower than control group at 10 minutes after extubated（P〈0.05）, surgeons＇ degree of satisfaction during operation was significantly higher than that of control group（P〈0.05）. Conclusion For patients with cervical cancer combined with hypertensive, the combination of Dexmedetomidine ＋ Propofol ＋ Remifentanil ＋ Rocuronium has better anesthetic effects, which helps patients wake up as soon as possible and reduce hemodynamic fluctuations, and safe and reliable as well.