右美托咪定对妇科腹腔镜手术患者异氟醚吸入麻醉的影响

Effect of Dexmedetomidine on Isoflurane Inhalation Anesthesia in Patients Undergoing Gynecological Laparoscopic Surgery

目的:分析妇科腹腔镜手术患者进行异氟醚吸入麻醉时,辅以右美托咪定的临床效果。方法:将笔者所在医院2019年9月-2020年9月接受治疗的120例妇科腹腔镜手术患者作为研究对象,通过随机数表法分为常规组(n=60)与观察组(n=60),常规组患者于麻醉诱导前静脉滴注生理盐水,观察组患者于麻醉诱导前静脉泵注右美托咪定,术中均采用异氟醚吸入麻醉。比较两组患者麻醉效果、麻醉前后血压、心率,以及术后不同时间疼痛情况、舒适度评分、镇静评分、精神状态评分及并发症发生率。结果:观察组麻醉诱导时间、术后睁眼时间、拔管时间均优于常规组(P<0.05)。观察组诱导后、插管时、气腹5 min、停药时血压高于常规组(P<0.05);观察组诱导后、插管时、气腹5 min、停药时心率低于常规组(P<0.05)。两组1、24 h疼痛程度比较差异无统计学意义(P>0.05),观察组2、6、12 h疼痛程度低于常规组(P<0.05)。两组1、24 h舒适度比较差异无统计学意义(P>0.05),观察组2、6、12 h舒适度高于常规组(P<0.05)。两组患者并发症发生率比较差异无统计学意义(P>0.05)。两组术后1 h镇静评分无统计学意义(P>0.05);观察组术后2、6、12、24 h镇静评分高于常规组(P<0.05)。观察组手术后3 d、1周的MMSE评分均高于常规组(P<0.05)。结论:右美托咪定的应用能够提高异氟醚吸入麻醉效果,改善患者血压、心率指标,同时能够提高患者舒适度,降低疼痛程度,可以考虑积极推广。

Objective:To analyze the clinical effect of Dexmedetomidine combined with Isoflurane inhalation anesthesia in patients undergoing gynecological laparoscopic surgery.Method:A total of 120 cases of gynecological laparoscopic surgery patients who received treatment from September 2019 to September 2020 in the author’s hospital were taken as the research objects,and they were divided into the routine group(n=60)and the observation group(n=60)through the random number table method.Patients in the routine group received intravenous infusion of Normal Saline before induction of anesthesia,and patients in the observation group received intravenous infusion of Dexmedetomidine before induction of anesthesia.Isoflurane inhalation anesthesia was used in both groups during the surgery.The effects of anesthesia,blood pressure,heart rate before and after anesthesia,pain,comfort score,sedation score,mental status score after surgery and complication rate were compared between the two groups of patients.Result:The anesthesia induction time,eye opening time after surgery and extubation time in the observation group were better than those in the routine group(P<0.05).At the moment of after induction,intubation,pneumoperitoneum 5 min and drug withdrawal,the blood pressure in the observation group were higher than those in the routine group(P<0.05).After induction,intubation,pneumoperitoneum 5 min and drug withdrawal,the heart rate in the observation group were lower than those in the routine group(P<0.05).There were no significant differences of the pain degrees at 1 h and 24 h between the two groups(P>0.05),and the pain degrees at 2 h,6 h and 12 h were lower in the observation group than those in the routine group(P<0.05).There were no differences in the comfort level at 1 h and 24 h between the two groups(P>0.05),and the comfort level at 2,6,12 h in the observation group were higher than those in the routine group(P<0.05).The difference of incidence of complications between the two group was not statistically significant(P>0.05).The sedation scores of the two groups was not statistically significant at 1 h after surgery(P>0.05),the sedation scores of the observation group at 2,6,12,24 h after surgery were higher than those of the routine group(P<0.05).The MMSE scores at 3 days and 1 week after surgery in the observation group were higher than those in the routine group(P<0.05).Conclusion:The application of Dexmedetomidine can improve the anesthetic effect in Isoflurane inhalation anesthesia,improve the blood pressure and heart rate of patients,improve the comfort lever and reduce the degree of pain,which can be actively promoted.