右美托咪定对腹腔镜子宫切除术中的应用探讨

Study on Application of Dexmedetomidin in the Laparoscopic Hysterectomy

目的探究右美托咪定在腹腔镜子宫切除术中的应用效果。方法选取该院2015年1月—2017年9月收治的114例腹腔镜子宫切除术患者,均行全身麻醉,按处理方式不同随机均分为两组,每组57例。将麻醉诱导前15 min注入0.9%氯化钠溶液者作为对照组,麻醉诱导前15 min泵入0.5μg/kg右美托咪定者作为研究组,比较两组麻醉恢复情况、镇痛评分及不良反应。结果研究组苏醒时间[(9.87±2.63)min vs(11.81±3.09)min,(t=3.609 6,P<0.01)]、自主呼吸恢复时间[(2.22±1.38)min vs(3.54±1.36)min,(t=5.143 6,P<0.01)]均短于对照组;研究组用药15 min后BIS值[(72.13±7.17)vs(96.41±1.79),(t=24.804 9,P<0.01)]、手术结束时[(54.65±8.25)vs(75.22±7.18),(t=14.199 7,P<0.01)]BIS值及苏醒后5 min VRS评分[(2.72±0.78)分vs(3.87±1.13)分,(t=6.323 3,P<0.01)]均优于对照组;研究组寒战(0.00%vs.15.78%),(χ~2=7.720 6,P<0.01)及恶心呕吐[(1.75%vs 17.54%),(χ~2=8.150 0,P<0.01)]发生率较对照组均显著低。结论腹腔镜子宫切除术患者全身麻醉诱导前15 min泵入右美托咪定可有效提高麻醉效果,且利于患者术后苏醒,不良反应减少,可推广。

Objective To study the application effect of dexmedetomidin in the laparoscopic hysterectomy.Methods 114 cases of patients with laparoscopic hysterectomy admitted and treated in our hospital from January 2015 to September 2017 were selected for general anesthesia,and randomly divided into two groups according to different treatment ways with 57 cases in each,the control group used the injection of 0.9%sodium chloride solution I 15 min after induction,while the research group used the pumping of 0.5μg/kg dexmedetomidin in 15 min before induction,and the anesthesia recovery,sedation score and adverse reactions were compared between the two groups.Results The awakening time and spontaneous breath recovery time in the research group were respectively[(9.87±2.63)min vs(11.81±3.09)min,(t=3.609 6,P<0.01)]and[(2.22±1.38)min vs(3.54±1.36)min,(t=5.143 6,P<0.01)],which were shorter than those in the control group,and the BIS values in 15min after medication and at the end of operation and VRS score in 5 min after awakening in the research group were respectively[(72.13±7.17)vs(96.41±1.79),(t=24.804 9,P<0.01)],[(54.65±8.25)vs(75.22±7.18),(t=14.199 7,P<0.01)]and[(2.72±0.78)points vs(3.87±1.13)points,(t=6.323 3,P<0.01),which were better than those in the control group,and the incidence rates of chill and vomiting and nausea in the research group were respectively[(0.00%vs 15.78%),(χ2=7.720 6,P<0.01)]and[(1.75%vs 17.54%),(χ2=8.150 0,P<0.01)],which obviously decreased compared with those in the control group.Conclusion The pumping of dexmedetomidin in 15 min after induction of anesthesia of patients with laparoscopic hysterectomy can effectively improve the anesthesia effect,which is conducive to the postoperative awakening with adverse reactions,which can be promoted.