右美托咪定联合舒芬太尼镇痛对妇科腹腔镜术后患者血流动力学、镇痛效果及不良反应的影响

Effects of Dexmedetomidine combined with Sufentanil on postoperative hemodynamics, analgesia and adverse reactions in patients undergone gynecologic laparoscopic surgeries

目的:观察右美托咪定联合舒芬太尼镇痛对妇科腹腔镜术后患者血流动力学、镇痛效果及不良反应的影响。方法:选取53例妇科腹腔镜手术患者为研究对象,按照随机数字表法将其分为观察组28例与对照组25例。两组患者均接受常规麻醉药物诱导及维持,在此基础上,对照组患者接受舒芬太尼镇痛,观察组在对照组基础上接受右美托咪定镇痛。比较两组术后各时段血流动力学水平和镇静、镇痛效果及不良反应发生率。结果:给药前(T1),两组HR、MAP指标比较,差异无统计学意义(P>0.05);拔管后5 min(T2),观察组HR、MAP与T1时比较,差异无统计学意义(P>0.05),而对照组HR、MAP较T1时明显上升(P<0.05),观察组HR、MAP明显低于对照组(P<0.05);术后6、12 h,两组RSS、VAS评分较术后2 h明显降低,且观察组VAS评分明显低于对照组,差异均有统计学意义(P<0.05);术后观察组不良反应发生率为10.71%(3/28),明显低于对照组的36.00%(9/25),差异有统计学意义(P<0.05)。结论:右美托咪定联合舒芬太尼镇痛对妇科腹腔镜术后患者能有效稳定血流动力学水平,提升镇痛效果和降低不良反应发生率,效果优于单纯舒芬太尼镇痛。

Objective: To observe effects of Dexmedetomidine combined with Sufentanil on postoperative hemodynamics, analgesia and adverse reactions in patients undergone gynecologic laparoscopic surgeries. Methods: 53 patients undergone the gynecologic laparoscopic surgeries were selected as the study subjects and divided into observation group(28 cases) and control group(25 cases) according to the random number table method. Both groups received routine anesthetic induction and maintenance. On this basis, the patients in the control group received Sufentanil analgesia, while those in the observation group received Dexmedetomidine combined with Sufentanil. The changes of hemodynamics, sedative and analgesic effects and the incidences of adverse reactions were compared between the two groups. Results: At T1, there were no significant differences in the indexes of HR and MAP between the two groups(P>0.05). At T2, the levels of HR and MAP in the observation group had no significant difference with those at T1(P>0.05), while the HR and MAP levels in the control group were significantly higher than those at T1, and the differences were statistically significant(P<0.05). The levels of HR and MAP in the observation group were significantly lower than those of the control group, and the differences were statistically significant(P<0.05). At 6 and 12 hours after the operation, the RSS and VAS scores of the two groups were significantly lower than those 2 hours after the operation;those in the observation group were significantly lower than those of the control group;and the differences were statistically significant(P<0.05). The total incidence of adverse reactions in the observation group(10.71%, 3/28) was significantly lower than that in the control group(36.00%, 9/25), and the difference was statistically significant(P<0.05). Conclusions: For the gynecological laparoscopic surgery patients, Dexmedetomidine combined with Sufentanil can effectively maintain the hemodynamic stability, improve the sedation and analgesia effects, and reduce the incidence of adverse reactions. Moreover, it is superior to single Sufentanil.