右美托咪定对妇科腔镜手术患者苏醒期的影响

The Effect of Dexmedetomidine on Restlessness and Stress Response in Patients Undergoing General Anesthesia Laparoscopic Surgery

目的探讨右美托咪定对妇科腹腔镜手术患者全麻苏醒期躁动及应激反应的影响。方法选取2018年12月—2020年4月本院收治的120例择期行妇科腹腔镜手术的患者,采用随机数字表法将其分为观察组及对照组,每组各60例。观察组患者在手术结束前30 min单次给予静脉微量泵注右美托咪定0.8μg/kg,10 min内注药完毕,对照组以同样方式输注等容量的生理盐水。记录两组患者苏醒时间、拔管时间、PACU停留时间、苏醒期Ramsay镇静评分及躁动评分,观察两组患者苏醒期外周血中皮质醇(Cor)及促甲状腺激素(TSH)水平变化。结果两组患者苏醒时间、拔管时间差异均无统计学意义(P>0.05),观察组在PACU停留时间较对照组缩短;与对照组相比,观察组Ramsay镇静评分明显更高(P<0.05),且躁动评分明显更低(P<0.05);观察组苏醒期血清中TSH、Cor水平均低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定应用于妇科腹腔镜手术中可以减少全麻苏醒期躁动发生,不会引起苏醒延迟或拔管时间延长,同时还能有效抑制患者麻醉后应激反应,提高全麻苏醒期患者的舒适性及安全性。

Objective To investigate the effect of dexmedetomidine on restlessness and stress response in patients undergoing gynecological laparoscopic surgery.Methods 120 patients undergoing elective gynecological laparoscopic surgery In our hospital from December 2018 to April 2020 were divided into observation group and control group according to random number table method,60 cases in each group.Patients in the observation group were given a single intravenous injection of dexmedetomidine 0.8μg/kg 30 minutes before the end of the operation,and the drug injection was completed within 10 minutes.The control group was infused with normal saline in the same manner.Record the recovery time,extubation time,PACU stay time,Ramsay sedation score and restlessness score of the two groups of patients,observe the changes of cortisol(Cor)and thyroid stimulating hormone(TSH)levels in the peripheral blood of the two groups of patients during the recovery period.Results There was no significant difference in recovery time and extubation time between the two groups(P>0.05);the PACU stay time in the observation group was shorter than that in the control group;compared with the control group,the Ramsay sedation score in the observation group was significantly increased(P<0.05),and the restlessness score was significantly reduced(P<0.05);the serum TSH and Cor levels in the recovery group were lower than the control group,the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine used in gynecological laparoscopic surgery can reduce the occurrence of restlessness during general anesthesia recovery period,will not cause recovery delay or extubation time extension,and can also effectively suppress the patient's post-anaesthesia stress response and improve the general anesthesia recovery period patients comfort and safety.