右美托咪定在侧卧位静脉麻醉下混合痔切除术中的应用

Application of dexmedetomidine in mixed hemorrhoidectomy under intravenous anesthesia in lateral decubitus position

目的分析右美托咪定在侧卧位静脉麻醉下混合痔切除术的应用效果。方法混合痔切除术病人60例,采用随机数字表法分为对照组和研究组,每组各30例。两组均予以异丙酚麻醉诱导,对照组予以瑞芬太尼加异丙酚麻醉维持,研究组予以瑞芬太尼加右美托咪定麻醉维持。比较两组瑞芬太尼、异丙酚用量,麻醉苏醒质量,不同时间点心率(HR)、平均动脉压(MAP)和脑电双频指数(BIS),视觉模拟评分(VAS)和不良反应发生情况。结果研究组异丙酚、瑞芬太尼用量少于对照组,差异有统计学意义(P<0.05)。两组呼吸恢复时间、清醒时间比较差异无统计学意义(P>0.05)。麻醉诱导前,两组HR、MAP和BIS比较差异无统计学意义(P>0.05);手术开始后10分钟时,两组HR、MAP均上升,研究组低于对照组,手术开始后10分钟BIS均下降,且研究组低于对照组,差异有统计学意义(P<0.05)。术后1小时、4小时,研究组VAS评分低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论混合痔切除术在静脉麻醉基础上给予右美托咪定未延迟病人苏醒时间,减少麻醉药物剂量,可保持血流动力学平稳并减轻疼痛,安全性高。

Objective To analyze the application effect of dexmedetomidine in mixed hemorrhoidectomy under intravenous anesthesia in lateral position.Methods 60 patients undergoing mixed hemorrhoidectomy were divided into control group and research group according to random number table method,with 30 cases in each group,and were divided into control group and research group according to random number table method,with 30 cases in each group.Both groups were induced by propofol anesthesia,the control group was maintained by remifentanil and propofol anesthesia,and the study group was maintained by remifentanil and dexmedetomidine anesthesia.The dosage of remifentanil and propofol,anesthesia recovery quality,heart rate(HR),mean arterial pressure(MAP),bispectral index(BIS),visual analogue scale(VAS),and adverse reactions were compared between the two groups.ResultsThe dosage of propofol and remifentanil in the research group was lesser than that in the control group(P<0.05).There was no significant difference in respiratory recovery time and awake time between the two groups(P>0.05).Before anesthesia induction,there was no significant difference in HR,MAP and BIS between the two groups(P>0.05).HR and MAP in both groups increased 10 min after the operation,while BIS in the research group was lower than that in the control group and decreased 10 min after the operation,and the research group was lower than that in the control group(P<0.05).The VAS score of the research group was lower than that of the control group 1 hour and 4 hours after operation(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Dexmedetomidine on the basis of intravenous anesthesia for mixed hemorrhoid resection does not delay the recovery time of patients and reduces the dosage of narcotic drugs,which can maintain stable hemodynamics and relieve pain,and has high safety.