右美托咪定与丙泊酚用于硬膜外麻醉下经皮肾镜钬激光碎石术镇静效果的对照研究

Comparative Study of Sedative Effects of Dexmedetomidine and Propofol in Percutaneous Nephroscopic Holmium Laser Lithotripsy under Epidural Anesthesia

目的 分析探讨右美托咪定与丙泊酚用于硬膜外麻醉下经皮肾镜钬激光碎石术镇静效果。方法 选取2017年12月—2020年6月该院收治的82例肾结石患者为研究对象,两组均进行硬膜外麻醉下经皮肾镜钬激光碎石术,按照编号分组,观察组41例,用右美托咪定麻醉;对照组41例,用丙泊酚麻醉。对两组呼吸恢复、睁眼、拔管时间进行对比,并评价两组不良反应、Ramsay评分,以及麻醉前后心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)。结果 与对照组相比,观察组睁眼时间(9.07±2.27)min,呼吸恢复时间(4.71±1.24)min,拔管时间(15.97±2.23)min短,差异有统计学意义(t=7.753、11.151、6.631,P<0.05)。观察组Ramsay评分麻醉中(3.84±0.81)分,麻醉后(4.07±0.88)分高于对照组,差异有统计学意义(t=9.193、7.410,P<0.05),观察组不良反应发生率4.88%少于对照组,差异有统计学意义(χ^(2)=5.145,P<0.05)。结论 右美托咪定用于硬膜外麻醉下经皮肾镜钬激光碎石术,镇静效果更佳,患者生命体征平稳,保证手术的顺利进行,缩短呼吸恢复、睁眼、拔管时间,安全性高。

Objective To analyze the sedative effect of dexmedetomidine and propofol in percutaneous nephroscopic holmium laser lithotripsy under epidural anesthesia. Methods Selected of 82 patients with kidney stones in the hospital who were treated from December 2017 to June 2020 were collected as the research objects. Both groups underwent percutaneous nephrolithotomy under epidural anesthesia and holmium laser lithotripsy, with dexmedetomidine anesthesia;41 cases in the control group,with propofol anesthesia. Respiratory recovery time, eye opening time, and extubation time were compared between the two groups, and adverse reactions, Ramsay scores, and heart rate(HR), mean arterial pressure(MAP), and blood oxygen saturation(SpO2) before and after anesthesia were evaluated in the two groups. Results Compared with the control group, the observation group opened eyes time(9.07±2.27) min, respiration recovery time(4.71±1.24) min, and extubation time(15.97±2.23) min were shorter, and the differences were statistically significant(t=7.753, 11.151, 6.631, P<0.05). The Ramsay score of the observation group during anesthesia(3.84±0.81)points and after anesthesia(4.07±0.88)points was higher than that of the control group, and the difference was statistically significant(t=9.193, 7.410, P<0.05). The incidence of adverse reactions in the observation group was 4.88%, which was less than that in the control group, the difference was statistically significant(χ^(2)=5.145,P<0.05). Conclusion Dexmedetomidine used in percutaneous nephrolithotripsy under epidural anesthesia has better sedative effect, stable vital signs of patients, ensuring the smooth operation, shortening the time of respiratory recovery, eye opening and extubation, with high safety.