盐酸右美托咪定在不同时间点应用于妇科腹腔镜手术对患者麻醉效果及术后复苏的影响研究

A Study of Anesthesia Effects and Postoperative Recovery Conditions with Dexmedetomidine Hydrochloride in Gynecological Laparoscopic Surgery at Different Time Periods

目的:研究不同时间点盐酸右美托咪定在妇科腹腔镜手术中的价值及对患者麻醉效果、术后复苏的影响。方法:选择本院2019年3月~2020年3月纳入的108例妇科腹腔镜手术患者,采用随机数字表法分为研究组和对照组,每组54例。两组患者采用相同的麻醉诱导和维持方案,研究组在诱导前15 min使用0.6μg/(kg·h)右美托咪定进行泵注,对照组在手术结束前15 min使用0.6μg/(kg·h)右美托咪定进行泵注,记录两组观察对象的拔管时长、术后苏醒,分别在苏醒即刻、术后12 h、1和3天测定两组的视觉模拟(VAS)、镇静(Ramsay)评分,最后评估两组术后恶心程度,对比两组麻醉效果。结果:研究组拔管时长、术后苏醒均优于对照组(P<0.05)。苏醒即刻两组的VAS和Ramsay对比无统计学差异(P>0.05),但术后12 h、1和3天的各项评分均低于对照组(P<0.05)。研究组术后恶心程度优于对照组(P<0.05)。结论:诱导前15 min使用盐酸右美托咪定的效果较好,能够有效提升妇科腹腔镜手术患者的麻醉效果,促进术后快速苏醒,迅速减轻疼痛与恶心程度,值得临床推广应用。

Objective:To study the anesthesia effects and postoperative recovery conditions with dexmedetomidine hydrochloride in gynecological laparoscopic surgery at different time periods.Methods:108 patients undergoing gynecological laparoscopic operation from March 2019 to March 2020 in our hospital were selected and randomly divided into research group(n=54)and control group(n=54).Both of groups took the same anesthesia induction and maintenance methods.The research group took 0.6μg/(kg·h)dexmedetomidine hydrochloride before 15 min of induction;the control group took 0.6μg/(kg·h)dexmedetomidine hydrochloride before 15 min of completing the surgery.Anesthesia onset time and postoperative recovery time were recorded.Visual analogue scale(VAS)and Ramsay scores at upon recovery,12 h,1 d and 3 d after surgery were recorded.Finally,the postoperative nausea degree of the two groups was evaluated and the anesthesia effect of the two groups was compared.Results:Anesthesia onset time and postoperative recovery time in the research group were better than control group(P<0.05);upon recovery,VAS and Ramsay scores between the two groups were not significantly different(P>0.05);however,12 h,1 d and 3 d after surgery,related scores in the research group were lower than control group(P<0.05);nausea degree in the research group was better than the control group(P<0.05).Conclusion:Before 15 min of induction,dexmedetomidine hydrochloride can effectively improve the anesthesia effects during gynecological laparoscopic operation,promote the fast recovery after surgery,and relieve the pain and nausea degree.It is worthy of promotion.