右美托咪定联合右旋氯胺酮诱导用于腹腔镜下子宫肌瘤微创手术可行性研究

Safety and Hemodynamic Stability of Dexmedetomidine Combined with S-ketamine Induction for Minimally Invasive Laparoscopic Surgery of Uterine Fibroids

目的分析右美托咪定联合右旋氯胺酮麻醉诱导用于腹腔镜下子宫肌瘤微创手术的可行性。方法选取淮南阳光新康医院2020年1月至2022年12月期间收治的78例子宫肌瘤腹腔镜微创手术患者作为研究对象,全部实施喉罩下全身麻醉,以抽签法分为对照组与观察组,每组39例。对照组给予咪达唑仑、舒芬太尼、依托咪酯及肌松药常规诱导,观察组使用右美托咪定联合右旋氯胺酮及肌松药进行诱导,术中两组均用瑞芬太尼联合丙泊酚维持。对比两组手术相关指标、血流动力学、不良反应等。结果观察组术中出血量、麻醉时间、手术时间、苏醒时间与自主呼吸恢复时间与对照组相比,差异无统计学意义(P>0.05);观察组HR(心率)、SpO_(2)(血氧饱和度)、MAP(平均动脉压)在T_(0)(麻醉诱导前)与对照组相比,差异无统计学意义(P>0.05),在T_(1)(麻醉诱导后)、T_(2)(拔管时)、T_(3)(拔管后30 min)时组间对比,差异有统计学意义(P<0.05);观察组不良反应发生率7.69%,低于对照组25.64%(P<0.05)。结论右美托咪定联合右旋氯胺酮麻醉用于腹腔镜下子宫肌瘤微创手术患者诱导,能够维持患者血流动力学稳定,不良反应较少。

Objective To analyze the safety and hemodynamic stability of dexmedetomidine combined with S-ketamine anesthesia for minimally invasive laparoscopic surgery of uterine fibroids.Methods 78 patients undergoing laparoscopic minimally invasive surgery for uterine fibroids admitted to Huainan Yangguang Xinkang Hospital from January 2020 to December 2022 were selected as the study subjects.All patients underwent general anesthesia under laryngeal mask,and were divided into a control group and an observation group by drawing lots,with 39 patients in each group.The control group received routine induction with midazolam,sufentanil,etomidate,and muscle relaxants,while the observation group received induction with dexmedetomidine combined with S-ketamine and muscle relaxants.Both groups were maintained with remifentanil combined with propofol during surgery.Compare the surgical related indicators,hemodynamics,and adverse reactions between the two groups.Results After treatment,the intraoperative bleeding volume,anesthesia time,and surgical time in the observation group were compared to the control group,the difference was not statistically significant(P>0.05),and the recovery time of awakening and spontaneous breathing were compared to the control group,the difference was not statistically significant(P>0.05);the HR(heart rate),SpO_(2)(blood oxygen saturation),and MAP(mean arterial pressure)of the observation group were compared with the control group at T_(0)(before anesthesia induction),the difference was not statistically significant(P>0.05),and compared between the groups at T_(1)(after anesthesia induction),T_(2)(during extubation),and T_(3)(30 minutes after extubation),the difference was statistically significant(P<0.05);the incidence of adverse reactions in the observation group was 7.69%,lower than 25.64%in the control group(P<0.05).Conclusion The combination of dexmedetomidine and S-ketamine anesthesia for induction of minimally invasive laparoscopic surgery for uterine fibroids can maintain hemodynamic stability,reduce adverse reactions,and ensure drug efficiency while also considering its safety.