右美托咪定复合麻醉在腹腔镜子宫切除术中效果及安全性评价

Clinical effect and safety evaluation of dexmedetomidine combined anesthesia during laparoscopic hysterectomy of patients

目的:分析右美托咪定用于腹腔镜子宫切除术中复合麻醉的效果及安全性。方法:选取2019年1月-2021年1月在本院行腹腔镜子宫切除术的患者120例随机分为观察组和对照组各60例,两组均采用相同诱导麻醉,对照组采用0.5ug/kg/h舒芬太尼麻醉维持,观察组给予0.5ug/kg/h右美托咪定复合麻醉。观察两组麻醉期间血流动力学指标变化,记录两组围术期指标及不良反应情况。结果:观察组在手术开始5min(T4)及拔管时(T6)时心率(HR)、平均动脉压(MAP)均低于对照组(P<0.05);两组在麻醉前(T1)、插管后5min(T2)、气腹创建5min(T3)、气腹结束后5min(T5)时HR、MAP及T1、T2、T3、T4、T5、T6时血氧饱和度(SpO_(2))均无差异(P>0.05)。观察组与对照组手术时间(68.2±9.7min、67.1±9.2min)、麻醉时间(48.8±7.1min、49.6±7.5min)、拔管时间(15.2±4.6min、14.9±4.3min)均无差异(P>0.05);观察组拔管躁动Riker评分(2.2±0.6分)低于对照组(1.1±0.3分),恶心呕吐(1.7%)及总不良反应发生率(6.7%)低于对照组(13.3%、23.3%)(均P<0.05)。结论:右美托咪定用于腹腔镜子宫切除术复合麻醉对患者围术期血流动力学影响较小,且可有效降低患者拔管躁动,麻醉效果和安全性均较好。

Objective:To analyze the effect and safety of dexmedetomidine combined anesthesia during laparoscopic hysterectomy of patients.Methods:A total of 120 patients who wanted laparoscopic hysterectomy were selected and randomly divided into two groups(60 cases in each group)from January 2019 to January 2021.The patients in the two groups were given the same induction anesthesia.The patients in the control group were given 0.5ug/kg/h sufentanil for maintaining anesthesia,and the patients in the observation group was given 0.5ug/kg/h dexmedetomidine combined anesthesia for maintaining anesthesia.The changes of hemodynamic indexes of the patients in the two groups during anesthesia were observed.The perioperative indicators and adverse reactions of the patients in the two groups were recorded.Results:The values of heart rate(HR)and mean arterial pressure(MAP)of the patients in the observation group at 5min after operation(T4)and at extubation(T6)were significantly lower than those of the patients in the control group(P<0.05).There were no significant differences in the values of HR,and MAP of the patients before anesthesia(T1),5min after intubation(T2),5min after pneumoperitoneum creation(T3),and 5min after pneumoperitoneum end(T5)between the two groups(P>0.05).There was no significant difference in SpO_(2) value of the patients at T1,T2,T3,T4,T5,and T6 between the two groups(P>0.05).There were no significant differences in the operation time(68.2±9.7min vs.67.1±9.2min),the anesthesia time(48.8±7.1min vs.49.6±7.5min),and the extubation time(15.2±4.6min vs.14.9±4.3min)of the patients between the two groups(P>0.05).The Riker score of extubation agitation(2.2±0.6 points),and the incidence of nausea and vomiting(1.7%)and total adverse reactions(6.7%)of the patients in the observation group were significantly lower than those(1.1±0.3 points,13.3%,and 23.3%)of the patients in the control group(all P<0.05).Conclusion:Dexmedetomidine combined anesthesia during laparoscopic hysterectomy has little influence on the perioperative hemodynamics of the patients,and which can effectively reduce the agitation of extubation with good anesthesia effect and safety.