右美托咪定对腹腔镜胆囊切除术患者七氟烷麻醉复苏期躁动的影响

Effect of dexmedetomidine on agitation during recovery from sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy

目的探讨右美托咪定对腹腔镜胆囊切除术患者七氟烷麻醉复苏期躁动的影响。方法70例行腹腔镜胆囊切除手术的患者,采用随机数字表法分为观察组和对照组,各35例。两组患者均行腹腔镜胆囊切除手术治疗,观察组麻醉诱导前予以静脉泵注右美托咪定,对照组则于麻醉诱导前予以静脉泵注同剂量生理盐水。比较两组患者不同时间点[手术结束前5 min(T0)、麻醉复苏拔管前(T1)、拔管后(T2)、拔管后5 min(T3)]血流动力学指标[经皮血氧饱和度(SpO_(2))、收缩压(SBP)、心率(HR)],躁动评分,躁动持续时间及躁动发生情况,复苏期视觉模拟评分法(VAS)疼痛分级。结果两组患者T0、T1、T2、T3时的SpO_(2)、SBP、HR水平比较差异均无统计学意义(P>0.05)。观察组患者躁动评分(2.36±0.42)分明显低于对照组的(3.26±0.28)分,躁动持续时间(8.48±2.14)min明显短于对照组的(13.18±2.06)min,差异均有统计学意义(P<0.05);观察组患者躁动发生率2.86%低于对照组的11.43%,但差异无统计学意义(P>0.05)。观察组患者复苏期VAS疼痛分级明显优于对照组,差异具有统计学意义(P<0.05)。结论右美托咪定能有效缓解并降低腹腔镜胆囊切除术患者七氟烷麻醉复苏期间的躁动行为,其对于稳定患者血流动力学、降低患者疼痛程度均具有重要意义,值得临床推广应用。

Objective To discuss the effect of dexmedetomidine on agitation during recovery from sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy.Methods A total of 70 patients undergoing laparoscopic cholecystectomy were divided into the observation group and the control group according to the random numerical table,with 35 patients in each group.Both groups underwent laparoscopic cholecystectomy,and the observation group was injected with dexmedetomidine intravenously before anesthesia induction,while the control group was injected with the same dose of normal saline intravenously before anesthesia induction.Both groups were compared in terms of hemodynamic indices[blood oxygen saturation(SpO_(2)),systolic blood pressure(SBP),heart rate(HR)],agitation score,duration of agitation and occurrence of agitation at different time points[5 min before the end of surgery(T0),before extubation(T1),after extubation(T2)and 5 min after extubation(T3)],and visual analogue scale(VAS)pain grading during recovery.Results The differences in SpO_(2),SBP,and HR levels at each time point of T0,T1,T2,and T3 between the two groups were not statistically significant(P>0.05).The agitation score of(2.36±0.42)points in the observation group was significantly lower than that of(3.26±0.28)points in the control group;the duration of agitation of(8.48±2.14)min in the observation group was significantly shorter than that of(13.18±2.06)min in the control group;the differences were all statistically significant(P<0.05).The incidence of agitation in the observation group was 2.86%,which was lower than that of 11.43% in the control group,but the difference was not statistically significant(P>0.05).The VAS pain grading in the observation group was significantly better than that in the control group during recovery,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine can effectively relieve and reduce agitation during recovery from sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy,which is of great significance for stabilizing patients'hemodynamics and reducing their pain level,and is worthy of clinical promotion and application.