右美托咪定联合氢吗啡酮在喉罩无肌松全麻宫腔镜手术中的应用

Application of Dexmedetomidine Combined with Hydromorphone in Hysteroscopic Surgery under Laryngeal Mask without Muscle Relaxant General Anesthesia

目的:探讨右美托咪定联合氢吗啡酮应用在喉罩无肌松全麻宫腔镜手术中的效果。方法:选择2021年1-12月于江阴市人民医院行喉罩无肌松全麻下宫腔镜手术患者58例,随机分为右美托咪定+氢吗啡酮组(DH组)、舒芬太尼组(SF组),每组29例。DH组麻醉诱导采用右美托咪定0.2μg/kg静注(≥10 min)联合氢吗啡酮0.02 mg/kg、丙泊酚2.5 mg/kg静注,SF组麻醉诱导采用舒芬太尼0.3μg/kg、丙泊酚2.5 mg/kg静注,两组麻醉维持均采用丙泊酚6 mg/kg静脉泵注。记录两组全麻诱导前(T_(0))、手术开始前(T_(1))、手术开始10 min后(T_(2))、手术结束(T_(3))的心率(HR)、平均动脉压(MAP)及T_(1)、T_(2)、T_(3)的脑电双频指数(BIS),记录两组手术时间、手术结束至苏醒时间及术中体动发生情况。结果:与SF组相比,DH组在T_(1)、T_(2)时HR、MAP均高于SF组,T_(1)、T_(2)时BIS均低于SF组,T_(3)时BIS高于SF组,术中体动发生率低于SF组,苏醒时间短于SF组,差异均有统计学意义(P<0.05)。结论:右美托咪定0.2μg/kg静注(≥10 min)联合0.02 mg/kg氢吗啡酮静注在喉罩无肌松全麻宫腔镜手术中的应用有效,术中麻醉平稳,苏醒迅速。

Objective:To investigate the effect of Dexmedetomidine combined with Hydromorphone application in hysteroscopic surgery under laryngeal mask without muscle relaxant general anesthesia.Method:From January to December 2021,58 patients undergoing hysteroscopic surgery in Jiangyin People's Hospital under aryngeal mask without muscle relaxant general anesthesia were selected and randomly divided into Dexmedetomidine+Hydromorphone group(DH group)and Sufentanil group(SF group),29 patients in each group.In the DH group,general anesthesia was induced with Dexmedetomidine 0.2μg/kg intravenously(≥10 min)combined with Hydromorphone 0.02 mg/kg and Propofol 2.5 mg/kg intravenously.In the SF group,general anesthesia was induced with Sufentanil 0.3μg/kg and Propofol 2.5 mg/kg intravenously,Propofol 6 mg/kg intravenous pump was used for anesthesia maintenance in both groups.Heart rate(HR)and mean arterial pressure(MAP)were recorded before induction of general anesthesia(T_(0)),before the start of surgery(T_(1)),10 min after the start of surgery(T_(2))and at the end of surgery(T_(3))in both groups.Bispectral index(BIS)at T_(1),T_(2) and T_(3) were recorded in both groups,and the time of surgery,the time of recovery from the end of surgery and the occurrence of intraoperative body movements were recorded in both groups.Result:Compared with SF group,HR and MAP of DH group were higher than those of SF group at T_(1) and T_(2),BIS at T_(1) and T_(2) were lower than those of SF group,BIS at T_(3) was higher than that of SF group,the incidence of intraoperative body movement was lower than that of SF group,and the recovery time was shorter than that of SF group,the differences were statistically significant(P<0.05).Conclusion:The application of Dexmedetomidine 0.2μg/kg intravenously(≥10 min)combined with Hydromorphone 0.02 mg/kg intravenously in hysteroscopic surgery under laryngeal mask without muscle relaxant general anesthesia is reasonable and effective,resulting in smooth intraoperative anesthesia and rapid awakening.