右美托咪定与异丙酚分别联合地佐辛对腹腔镜妇科手术患者的麻醉效果对比

Anesthetic effects of dexmedetomidine and propofol respectively combined with dezocine on patients undergoing laparoscopic gynecological operation

目的对比观察右美托咪定与异丙酚分别联合地佐辛对腹腔镜妇科手术患者的麻醉效果。方法抽取2017年10月至2020年12月洛阳市第一人民医院收治的60例腹腔镜妇科手术患者为研究对象,采用随机数字表法分为对照组(30例)和观察组(30例),对照组行异丙酚联合地佐辛麻醉,观察组行右美托咪定联合地佐辛麻醉,比较两组患者血流动力学、意识状态、疼痛程度、认知功能。结果观察组呼吸频率(RR)、血氧饱和度(SPO2)指标在手术开始60 min(T2)时均高于对照组,平均动脉压(MAP)在麻醉诱导2 min(T1)、T2、手术结束时(T3)高于对照组(P<0.05);观察组拔管时、离开手术室时、拔管1 h的警觉-镇静量表(OAAS)评分均高于对照组(P<0.05);观察组2、4、8 h疼痛视觉模拟评分(VAS)评分低于对照组(P<0.05);两组术前,术后1、3 h简易精神状态检查量表(MMSE)评分比较,差异未见统计学意义(P>0.05)。结论右美托咪定与异丙酚分别联合地佐辛麻醉对腹腔镜妇科手术患者术后认知功能的影响接近,但右美托咪定联合地佐辛可改善患者意识状态和稳定呼吸、循环系统。

Objective To observe the anesthetic effects of dexmedetomidine and propofol respectively combined with dezocine on patients undergoing laparoscopic gynecological operation.Methods Sixty patients who underwent laparoscopic gynecological operation in the First People’s Hospital of Luoyang from October 2017 to December 2020 were selected as the study subjects.According to the random number table method,the patients were divided into control group(n=30)and observation group(n=30).The control group was anesthetized with propofol and dezocine,while the observation group was anesthetized with dexmedetomidine and dezocine.Hemodynamics,state of consciousness,pain degree and cognitive function were compared between the two groups.Results The respiratory rate(RR)and blood oxygen saturation(SPO2)at 60 min after operation(T2)in the obser vation group were higher than those in the control group.The mean arterial pressure(MAP)at 2 min after anesthesia induction(T1),T2,and at the end of operation(T3)was higher than that of the control group(P<0.05).The Observer’s Alertness Assessment Sedation Scale(OAAS)scores of the observation group at extubation,leaving the operating room,and 1 h after extubation were higher than those of the control group(P<0.05).The pain visual analogue scale(VAS)scores of the observation group at 2,4,and 8 h after operation were lower than those of the control group(P<0.05).There were no statistically significant differences in mini-mental state examination(MMSE)scores between the two groups before operation,1 h after operation,and 3 h after operation(P>0.05).Conclusions Dexmedetomidine and propofol respectively combined with dezocine have similar effects on postoperative cognitive function in patients undergoing laparoscopic gynecological operation,but dexmedetomidine combined with dezocine can improve the patient’sconsciousness,and stabilize respiratory system and circulation system.