右美托咪定预防腹腔镜胆囊切除术患者术后恶心呕吐的效果观察

Effect Observation of Dexmedetomidine on Preventing Postoperative Nausea and Vomiting of Patients with Laparoscopic Cholecystectomy

目的:分析右美托咪定预防腹腔镜胆囊切除术患者术后恶心呕吐的效果。方法:选取2020年10月-2021年10月湖南省人民医院收治的80例腹腔镜胆囊切除术患者作为研究对象,经双盲法分为试验组与参照组,各40例。试验组应用右美托咪定持续泵注,参照组应用生理盐水持续泵注。分析两组患者麻醉前、插管后5 min、手术后的手术应激情况,术后恶心呕吐发生率及疼痛程度。结果:麻醉前,两组患者皮质醇、肾上腺素水平比较,差异无统计学意义(P>0.05);插管后5 min与手术后,试验组皮质醇、肾上腺素水平均低于参照组,差异有统计学意义(P<0.05)。术后3 h、6 h,试验组疼痛评分低于参照组,差异有统计学意义(P<0.05);术后12 h、24 h,两组疼痛评分比较,差异无统计学意义(P>0.05)。试验组患者术后恶心呕吐发生率低于参照组,差异有统计学意义(P<0.05)。结论:在腹腔镜胆囊切除术患者麻醉诱导前静脉滴注右美托咪定,术中持续维持,可以稳定患者术中应激指标水平,降低术后疼痛程度与恶心呕吐发生率。

Objective:To analyze the effect of dexmedetomidine on preventing postoperative nausea and vomiting of patients with laparoscopic cholecystectomy.Methods:From October 2020 to October 2021,80 patients with laparoscopic cholecystectomy in Hunan Provincial People's Hospital were selected as the study subjects.They were divided into the experimental group and the reference group by double-blind method,with 40 cases in each group.The experimental group was continuously pumped with dexmedetomidine and the reference group was continuously pumped with physiological saline.The surgical stress before anesthesia,at 5 minutes after intubation and after surgery,the incidence of postoperative nausea and vomiting,and the degree of pain were analyzed in the two groups.Results:Before anesthesia,the levels of cortisol and epinephrine between the two groups showed no statistically significant difference(P>0.05).At 5 minutes after intubation and after surgery,the levels of cortisol and epinephrine in the experimental group were lower than those in the reference group,and the differences were statistically significant(P<0.05).At 3 hours and 6 hours after surgery,the pain score in the experimental group was lower than that in the reference group,and the difference was statistically significant(P<0.05).At 12 hours and 24 hours after surgery,there was no statistically significant difference in pain scores between the two groups(P>0.05).The incidence of postoperative nausea and vomiting in the experimental group was lower than that in the reference group,and the difference was statistically significant(P<0.05).Conclusion:For the patients undergoing laparoscopic cholecystectomy,intravenous drip of dexmedetomidine before anesthesia induction and continuous maintenance during surgery can stabilize the level of stress indicators during surgery,and reduce the degree of postoperative pain and the incidence of postoperative nausea and vomiting.The application of dexmedetomidine in the intervention of patients undergoing laparoscopic cholecystectomy to prevent postoperative nausea and vomiting is worthy of promotion.