七氟烷吸入全麻后持续泵入右美托咪定对腹腔镜胆囊切除患者镇痛效果及睡眠的影响

Effect of Continuous Pumping Dexmedetomidine after Sevoflurane Inhalation General Anesthesia on Analgesia and Sleep in Patients with Laparoscopic Cholecystectomy

目的:研究分析腹腔镜胆囊切除术(LC)患者实行七氟烷吸入全麻后持续泵入右美托咪定的镇痛效果及睡眠质量。方法:选取2020年1月至2021年4月兴义市人民医院收治的LC患者86例作为研究对象,按照不同麻醉方式进行分组,每组43例。对照组采用七氟烷吸入麻醉,观察组采用七氟烷吸入复合右美托咪定持续泵注麻醉,观察并分析2组麻醉的效果。结果:观察组术后第1天N1期、N2期、N3期、REM和主观睡眠质量评分与对照组比较结果较优,差异均有统计学意义(均P<0.05)。T1、T2、T3时刻,观察组的视觉模拟评分法(VAS)和Ramasy评分比较,差异均有统计学意义(均P<0.05);T4、T5时刻,组间VAS和Ramasy评分比较,差异均无统计学意义(均P>0.05)。组间麻醉诱导前血清皮质醇(COR)和去甲肾上腺素(NA)比较,差异均无统计学意义(均P>0.05);气腹建立和拔管后时期,观察组COR和NA均优于对照组,差异均有统计学意义(均P<0.05)。不良反应发生率比较,观察组较对照组更低,差异有统计学意义(P<0.05)。结论:应用七氟烷吸入复合右美托咪定持续泵注麻醉效果突出,能有效提高腹腔镜胆囊切除患者镇痛镇静作用,减少术后应激反应,睡眠质量趋于稳定。

Objective:To study and analyze the analgesic effect and sleep quality of continuous pumping of dexmedetomidine after sevoflurane inhalation general anesthesia in patients undergoing laparoscopic cholecystectomy(LC).Methods:A total of 86 patients with laparoscopic cholecystectomy admitted to Xingyi People′s Hospital from January 2020 to April 2021 were selected as the research objects.They were divided into groups according to different anesthesia methods,with 43 patients in each group.The control group was anesthetized by sevoflurane inhalation and the observation group was anesthetized by sevoflurane inhalation combined with dexmedetomidine continuous pumping.The effects of anesthesia in the two groups were observed and analyzed.Results:The scores of N1,N2,N3,REM and subjective sleep quality in the observation group on the first day after operation were better than those in the control group(P s<0.05).At T1,T2 and T3,the Visual Analogue Scale(VAS)and Ramasy scores of the observation group were significantly different(P s<0.05).There was no significant difference in VAS and Ramasy scores between groups at T4 and T5(P s>0.05).There was no significant difference in serum cortisol(COR)and noradrenaline(NA)between groups before anesthesia induction(P s>0.05);In the period of pneumoperitoneum establishment and after extubation,COR and NA in the observation group were better than those in the control group,and the differences were statistically significant(P s<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:The application of sevoflurane inhalation combined with dexmedetomidine continuous pumping anesthesia has outstanding anesthesia effect,which can effectively improve the analgesic and sedative effects of patients with laparoscopic cholecystectomy,reduce postoperative stress response,and stabilize sleep quality.