右美托咪定复合地佐辛在无痛胃肠息肉切除术中的应用及对患者血液动力学的影响

Application of dexmedetomidine combined with dezocine in painless gastrointestinal polypectomy and its effects on hemodynamics

目的研究右美托咪定(DEX)复合地佐辛(DEZ)在无痛胃肠息肉切除术中的应用及对患者血液动力学的影响。方法将本院2016年6月至2017年6月间收治的120例行胃肠息肉切除术患者,分为观察组(常规麻醉+右美托咪定+地佐辛)60例与对照组(常规麻醉)60例,记录两组术中各时间点血流动力学相关参数,比较两组麻醉苏醒后腹部疼痛情况与麻醉苏醒期躁动情况。结果与对照组比较,观察组围术期血流动力学指标HR、RR及SpO2波动更为稳定,差异有统计学意义(P<0.05);两组麻醉苏醒后腹部疼痛力度在1h、3h、12h、24h内均呈阶梯状下降,组内差异有统计学意义(P<0.05),且观察组各时间点VAS得分均明显低于对照组,差异有统计学意义(P<0.05);观察组麻醉苏醒期躁动情况显著优于对照组,差异有统计学意义(P<0.05)。结论DEX联合DEZ可有效减少胃肠息肉切除术患者围术期血流动力学波动幅度,减轻患者麻醉失效后腹腔疼痛力度并改善麻醉苏醒期躁动情况。

Objective To study the application of dexmedetomidine (DEX) combined with dezocine (DEZ) in painless gastrointestinal polypectomy and its effects on hemodynamics of patients. Methods 120 cases of patients with gastrointestinal polypectomy admitted to the hospital from June 2016 to June 2017 were divided into observation group (conventional anesthesia + dexmedetomidine + dezocine, 60 cases) and control group (conventional anesthesia, 60 cases). The related hemodynamic parameters at each time points during operation were recorded in the two groups, and the abdominal pain after anesthesia recovery and agitation during anesthesia recovery were compared between the two groups. Results Compared with control group, the fluctuations of perioperative hemodynamic parameters HR, RR and SpO2 were more stable in observation group, the difference was statistically significant (P<0.05). The abdominal pain intensity at 1 h, 3 h, 12 h and 24 h after anesthesia recovery showed step-like descent in the two groups, the difference was statistically significant (P<0.05), and the VAS score at each time point in observation group was significantly lower than that in control group, the difference was statistically significant (P<0.05). The agitation during anesthesia recovery in observation group was significantly better than that in control group, the difference was statistically significant (P<0.05). Conclusions DEX combined with DEZ can effectively reduce the perioperative hemodynamic fluctuations of patients with gastrointestinal polypectomy, reduce the pain intensity of abdominal cavity after anesthesia failure, and improve the agitation during anesthesia recovery.