依托咪酯复合右美托咪定对喉罩全麻下乳腺手术患者HR、MAP以及SpO_(2)的影响

Effect of Etomidate Combined with Dexmedetomidine on HR,MAP and SpO_(2) in Patients Undergoing Breast Surgery under General Anesthesia with Laryngeal Mask

目的分析喉罩全麻下乳腺手术患者应用依托咪酯复合右美托咪定的效果对其血流动力学的影响,并评估其在乳腺手术中的应用价值。方法回顾性分析2019年1月-2021年1月在该院行喉罩全麻下手术的60例乳腺疾病患者,对照组和研究组均为30例。其中,对照组麻醉使用依托咪酯,研究组在上述麻醉基础上,于麻醉诱导前10 min,予以0.5μg/kg的右美托咪定,观察两组麻醉情况。结果研究组术后呼吸恢复时间(4.08±0.97)min、呼之睁眼时间(8.76±1.45)min、定向力恢复时间(12.96±2.74)min及喉罩拔出时间(10.85±1.76)min,与对照组各指标比较均显著较短,差异有统计学意义(t=3.405、4.702、4.441、5.959,P<0.05)。研究组T2、T3、T4、T5时的HR、MAP水平与对照组比较,差异有统计学意义(t=6.040、4.559、4.739、5.519,P<0.05)。两组T2、T3、T4、T5时的MAP水平比较,差异有统计学意义(t=9.016、8.048、10.275、7.811,P<0.05)。两组Ta、Tb、Tc时刻的Ppeak、PETCO_(2)水平无明显差异,两组不良反应比较,差异无统计学意义(χ^(2)=0.000,P>0.05)。结论乳腺手术应用依托咪酯与右美托咪定复合麻醉能够使患者围手术期血流动力学更为平稳,缩短恢复时间,降低手术风险,提高安全性,值得在临床广泛推广。

Objective To analyze the effect of etomidate combined with dexmedetomidine on hemodynamics in patients undergoing breast surgery under general anesthesia with laryngeal mask,and to evaluate its application value in breast surgery.Methods A retrospective analysis of 60 patients with breast disease who underwent general anesthesia with laryngeal mask in the hospital from January 2019 to January 2021,30 cases in both the control group and the study group.Among them,the control group was anesthetized with etomidate,and the study group was given 0.5μg/kg dexmedetomidine 10 minutes before induction of anesthesia on the basis of the above anesthesia,and the anesthesia of the two groups was observed.Results The postoperative breathing recovery time of the study group was(4.08±0.97)min,the eye opening time(8.76±1.45)min,the orientation recovery time(12.96±2.74)min,and the laryngeal mask removal time(10.85±1.76)min,and The comparison of the indicators in the control group was significantly shorter,and the difference was statistically significant(t=3.405,4.702,4.441,5.959,P<0.05).Compared with the control group,the HR and MAP levels of the study group at T2,T3,T4,and T5 were statistically significant(t=6.040,4.559,4.739,5.519,P<0.05).The comparison of MAP levels at T2,T3,T4,and T5 between the two groups was statistically significant(t=9.016,8.048,10.275,7.811,P<0.05).There was no significant difference in Ppeak and PETCO_(2) levels at Ta,Tb,and Tc between the two groups.There was no statistically significant difference in adverse reactions between the two groups(χ2=0.000,P>0.05).Conclusion The combined anesthesia of etomidate and dexmedetomidine in breast surgery can make the patient's perioperative hemodynamics more stable,shorten the recovery time,reduce the surgical risk,and improve the safety.It is worthy of widespread clinical application.