右美托咪定对腹腔镜胆囊切除术患者围手术期监测参数和恢复的影响

Effects of Dexmedetomidine on Perioperative Monitoring Parameters and Recovery of Patients Undergoing Laparoscopic Cholecystectomy

探讨了右美托咪定在进行腹腔镜胆囊切除术的患者围手术期提供的血流动力学稳定性以及从麻醉中恢复的功效。本研究纳入了2018年6月至2019年1月期间于该院全身麻醉下进行选择性腹腔镜胆囊切除术的240例患者。按照随机对照原则,将其随机分为实验组(n=120)和对照组(n=120),实验组以0.5μg/(kg·h)的剂量给予右美托咪定输液,时间为10 min,对照组患者给予0.4μg/(kg·h)正常生理盐水,两组均采用七氟烷作为吸入剂,记录围手术期监测参数,评估术后镇静和恢复情况。结果显示,在注射右美托咪定之前,两组患者的HR值无明显差异,但是在静脉注射研究药物后至术后拔管清醒恢复期间,与对照组相比,实验组患者的HR值均显著降低,两组差异具有统计学意义(P<0.05)。在注射右美托咪定之前,两组患者的MAP值无明显差异,但是在静脉注射研究药物后至术后拔管清醒恢复期间,与对照组相比,实验组患者的MAP值均显著降低,两组差异具有统计学意义(P<0.05)。实验组中并未发现有恶心呕吐、低血压或心率过缓的患者,而对照组中存在4名患者术后出现恶心呕吐现象,两组的术后并发症差异具有统计学意义(P<0.05)。右美托咪定在腹腔镜手术麻醉期间能够有效控制和稳定患者的血流动力,并能减少术后的舒芬太尼补给量,减少术后不良并发症发生的情况。

This study focused on the hemodynamics provided by dexmedetomidine during the perioperative period in patients undergoing laparoscopic cholecystectomy.Stability and efficacy of recovery from anesthesia.The study included elective laparoscopy under general anaesthesia at the institution between June 2018 and January 2019240 patients underwent cholecystectomy.According to the randomized control principle,the patients were randomly assigned to an experimental group(n=120)and a control group(n=120).The experimental group was given dexmedetomidine infusion at a dose of 0.5μg/(kg·h)for 10 minutes,and the control group was given 0.4μg/(kg·h)normal saline.Sevoflurane was used as an inhalant in both groups.Perioperative monitoring parameters were recorded.Postoperative sedation and recovery were assessed.The results showed no significant difference in HR values between the two groups before dexmedetomidine infusion,but in the intravenous study the HR values of the patients in the experimental group were significantly lower than those in the control group during the period from post-drug to post-operative extubation awake recovery(P<0.05).Before dexmedetomidine injection,there was no significant difference in MAP values between the two groups,but after intravenous injection of the study drug until postoperative extubation,during the recovery period of sobriety,the MAP values of patients in the experimental group were significantly lower than those in the control group,and the difference between the two groups was statistically significant(P<0.05).Nausea and vomiting,hypotension,or bradycardia were not found in the experimental group,whereas four patients in the control group had postoperative nausea,the differences in postoperative complications between the two groups were statistically significant(P<0.05).Dexmedetomidine was effective in controlling and stabilizing patients’hemodynamics during anesthesia for laparoscopic surgery,and it could reduce postoperative fentanyl resupply to reduce the occurrence of adverse postoperative complications.