研究腹腔镜肝胆手术围术期采用不同剂量右美托咪定全身麻醉的效果

Specific Effect of Different Doses of Dexmedetomidine General Anesthesia in Laparoscopic Hepatobiliary Surgery

目的分析研究腹腔镜肝胆手术围术期采用不同剂量右美托咪定全身麻醉的效果。方法选择自2019年1月至2020年5月,在我院进行腹腔镜肝胆手术的50例右美托咪定全身麻患者。按右美托咪定的剂量不同分为参照组和观察组,每组各25例患者。患者围术期选择右美托咪定作为麻醉镇静药品,其中参照组选用0.35μg/kg的右美托咪定,观察组选用0.75μg/kg的右美托咪定。观察记录患者围术期间泵入右美托咪定时的心率(HR),以及麻醉后的镇静评分(Ramsay),并详细记录两组患者的拔管时间以及Aldrete苏醒评分结果,最后对比两组患者不良反应发生情况。结果观察组患者的HR指标及Ramsay评分结果优于参照组(P<0.05);观察组不良反应发生率低于参照组(P<0.05);两组患者拔管时间基本相似(P>0.05),差异无统计学意义;观察组Aldrete苏醒评分优于参照组(P<0.05),差异有统计学意义。结论腹腔镜肝胆手术选用0.75μg/kg的右美托咪定后的麻醉镇静,能够显著提升镇静评分(Ramsay)以及Aldrete苏醒评分,同时还能够最大限度地降低患者麻醉期间的不良反应。因此,建议在腹腔镜肝胆手术中选择0.75μg/kg剂量的右美托咪定。

Objective To analyze the specific effect of different doses of dexmedetomidine general anesthesia in lap⁃aroscopic hepatobiliary surgery.Methods From January 2019 to May 2020,50 patients with dexmedetomidine general anesthesia undergoing laparoscopic hepatobiliary surgery in our hospital were selected.According to the different doses of dexmedetomidine,they were divided into the reference group and the observation group,25 cases in each group.Dexmedetomidine was selected as sedative drug in perioperative period.The reference group was given 0.35μg/kg dexmedetomidine,and the observation group was given 0.75μg/kg dexmedetomi⁃dine.The heart rate(HR)at the time of dexmedetomidine infusion and the sedation score(Ramsay)after anes⁃thesia were observed and recorded.The extubation time and Aldrete recovery score of the two groups were re⁃corded in detail.The adverse reactions of the two groups were compared.Results The HR index and Ramsay score of the observation group were better than those of the reference group(P<0.05);the incidence of adverse reactions of the observation group was lower than that of the reference group(P<0.05);the extubation time of the two groups was basically similar(P>0.05),and the difference was not statistically significant;the Aldrete re⁃covery score of the observation group was better than that of the reference group(P<0.05),and the difference was statistically significant.Conclusion Dexmedetomidine of 0.75μg/kg has better sedation effect in laparoscopic hepatobiliary surgery,which can significantly improve the sedation score(Ramsay)and Aldrete recovery score,and also can minimize the adverse reactions during anesthesia.Therefore,it is suggested that 0.75μg/kg dexme⁃detomidine should be used in laparoscopic hepatobiliary surgery.