右美托咪定复合瑞芬太尼静脉麻醉在女性尿道憩室切除尿道重建术患者中的效果

Effect of dexmedetomidine combined with remifentanil intravenous anesthesia in female patients undergoing urethral reconstruction after resection of urethral diverticulum

目的探讨右美托咪定复合瑞芬太尼静脉麻醉在择期行女性尿道憩室切除尿道重建术患者中的麻醉效果.方法选取2016年9月至2019年10月本院收治的98例女性尿道憩室患者为研究对象。采用随机数字表法分为观察组(49例)与对照组(49例),对照组采取丙泊酚复合瑞芬太尼麻醉,观察组采取右美托咪定复合瑞芬太尼麻醉。观察两组患者的麻醉效果、血流动力学指标、不良反应及尿道症状体征等。结果观察组的手术时间、麻醉苏醒时间及疼痛评分均低于对照组(P<0.05)。观察组T1、T4时间点的呼吸频率(RR)和血氧饱和度(SpO_(2))明显高于对照组(P<0.05),T2、T3时间点的心率(HK)和平均动脉压(MAP)明敁低于对照组(P<0.05)。观察组的药物不良反应发生率低于对照组(6.12%vs.22.45%,P<0.05)。两组术后的症状体征发生率较术前降低,差异有统计学意义(P<O.05)。结论对女性尿道憩室切除尿道重建术患者行右美托咪定复合瑞芬太尼静脉麻醉,麻醉效果确切,能降低术后疼痛程度,可减轻呼吸抑制及不良反应,且术后苏醒迅速,是一种安全稳定的麻醉方法。

Objective To investigate the effect of dexmedetomidine combined with remifentanil intravenous anesthesia in female patients undergoing urethral reconstniction after resection of urethral diverticulum.Methods A total of 98 female patients with urethral diverticulum admitted to the hospital from September 2016 to October 2019 were selected and randomly divide into the observation group(49 cases)and the control group(49 cases).The control group was anesthetized with propofol combined with remifentanil,and the observation group was anesthetized with dexmedetomidine combined with remifentanil.Anesthesia effect,hemodynamic stability,adverse reactions and urethral signs of the two groups of patients were observed.Results Operation time,recovery time from anesthesia and pain score of the observation group were lower than those of the control group(P<0.05).The RR and SpO_(2) of the observation group at T1 and T4 were significantly higher than those of the control group(P<0.05),and the HR and MAP at T2 and T3 were significantly lower than those of the control group(P<0.05).The incidence of adverse drug reactions in the observation group was lower than that in the control group(6.12%vs.22.45%,P<0.05).Compared with before operation,observation group and the control group had significant difference in the incidence of postoperative symptoms and signs(P<0.05).Conclusions Intravenous anesthesia of dexmedetomidine combined with remifentanil has a definite anesthesia effect for female patients undergoing urethral diverticulum resection and urethral reconstruction,which can effectively reduce postoperative pain,relieve respiratory depression and adverse reactions,and wake quickly after surgery.It is a safe and stable anesthesia method.