七氟烷联合右美托咪定对腹腔镜下子宫肌瘤切除术患者生命体征、血清炎性因子和疼痛介质P物质、前列腺素E_(2)的影响

Effects of Sevoflurane Combined with Dexmedetomidine on Vital Signs,Serum Inflammatory Factors,Pain Mediators Substance P and Prostaglandin E_(2) in Patients Undergoing Laparoscopic Myomectomy

目的:探讨七氟烷联合右美托咪定对腹腔镜下子宫肌瘤切除术患者生命体征、血清炎性因子和疼痛介质P物质(SP)、前列腺素E2(PGE2)的影响。方法:选取安徽医科大学附属合肥医院2019年8月~2022年1月期间择期行腹腔镜下子宫肌瘤切除术患者92例。根据随机数字表法将入选患者分为对照组(46例)和研究组(46例)。对照组接受七氟烷麻醉,研究组接受七氟烷联合右美托咪定麻醉,比较两组生命体征、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-1β(IL-1β)]、疼痛指标[视觉疼痛模拟评分(VAS)、SP、PGE_(2)]、苏醒质量和不良反应发生率。结果:研究组插管后5 min(T1)、术毕(T2)心率(HR)、平均动脉压(MAP)低于对照组(P<0.05)。研究组术后24 h(T3)、术后48 h(T4)TNF-α、IL-6、IL-1β低于对照组(P<0.05)。研究组T3、T4时VAS、PGE_(2)、SP低于对照组(P<0.05)。两组苏醒时间、拔管时间无显著差异(P>0.05)。研究组的躁动评分小于对照组(P<0.05)。两组不良反应发生率组间对比无差异(P>0.05)。结论:腹腔镜下子宫肌瘤切除术中应用七氟烷联合右美托咪定,可使术后躁动减轻,血流动力学稳定,有效改善术后疼痛和炎性反应。

Objective:To investigate the effects of sevoflurane combined with dexmedetomidine on vital signs,serum inflammatory factors and pain mediators substance P(SP)and prostaglandin E_(2)(PGE_(2))in patients undergoing laparoscopic myomectomy.Methods:A total of 92 patients who underwent elective laparoscopic myomectomy from August 2019 to January 2022 in our hospital were selected.The enrolled patients were divided into control group(46 cases)and study group(46 cases)according to random number table method.The control group received sevoflurane anesthesia,the study group received sevoflurane combined with dexmedetomidine anesthesia.Vital signs,serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)],pain indexes[visual pain analog score(VAS),SP,PGE_(2)],recovery quality and incidence of adverse reactions were compared between the two groups.Results:The heart rate(HR)and mean arterial pressure(MAP)of the study group at 5min after intubation(T1)and after operation(T2)were lower than those of the control group(P<0.05).TNF-α,IL-6 and IL-1βof the study group were lower than those of the control group at 24 h after operation(T3)and 48 h after operation(T4)(P<0.05).VAS,PGE_(2) and SP of the study group at T3 and T4 were lower than those in the control group(P<0.05).There were no significant differences in recovery time and extubation time between the two groups(P>0.05).The agitation score of the study group was lower than that of the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Sevoflurane combined with dexmedetomidine in laparoscopic myomectomy can reduce postoperative agitation,stabilize hemodynamics,and effectively improve postoperative pain and inflammatory response.