右美托咪定联合不同剂量盐酸纳布啡对腹腔镜结肠癌根治术的麻醉效果

Effect of Dexmedetomidine Combined with Different Doses of Nalbuphine Hydrochloride in Anesthesia of Laparoscopic Radical Surgery for Colon Cancer

目的:研究分析右美托咪定联合不同剂量盐酸纳布啡对腹腔镜结肠癌根治术患者的麻醉效果。方法:选取台山市人民医院2021年4月—2023年4月收治的82例行腹腔镜结肠癌根治术患者作为研究对象,按照随机抽签法分为观察组(n=41)和对照组(n=41)。两组患者入院后进行术前准备,均予以咪达唑仑注射液、枸橼酸芬太尼注射液、丙泊酚注射液、苯磺酸阿曲库铵注射液麻醉诱导后行气管插管,同时采用丙泊酚注射液靶控输注或1.5%~2.5%的吸入用七氟醚、注射用盐酸瑞芬太尼维持麻醉。在上述基础上对照组采用右美托咪定联合低剂量盐酸纳布啡(0.15 mg/kg)进行辅助麻醉和术后自控静脉镇痛(PCIA),观察组采用右美托咪定联合高剂量盐酸纳布啡(0.6 mg/kg)进行辅助麻醉和术后PCIA,两组右美托咪定剂量相同。对比两组麻醉效果。结果:观察组手术时间、拔管时间、肛门排气时间、住院时间以及失血量与对照组比较,差异无统计学意义(P>0.05)。观察组麻醉和术后镇痛总有效率高于对照组,不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:在腹腔镜结肠癌根治术患者麻醉中采用右美托咪定联合高剂量盐酸纳布啡进行辅助麻醉和术后PCIA,其麻醉和术后镇痛效果更好,并且安全性佳。

Objective:To study and analyze the anesthetic effect of dexmedetomidine combined with different doses of nalbuphine hydrochloride on patients undergoing laparoscopic radical surgery for colon cancer.Methods:82 cases of laparoscopic radical colon cancer surgery patients admitted to Taishan City People's Hospital from April 2021 to April 2023 were selected as the study subjects,and were divided into the observation group(n=41)and the control group(n=41)according to the method of randomized draw.The patients in both groups were admitted to the hospital for surgery preparation,and were tracheally intubated after induction of anesthesia with midazolam injection,fentanyl citrate injection,propofol injection,and phenylsulfonylatracurium injection,and anesthesia was maintained with target-controlled infusion of propofol injection,or 1.5%to 2.5%sevoflurane for inhalation,and remifentanil hydrochloride for injection.On the basis of the above,the control group used dexmedetomidine combined with low-dose nalbuphine hydrochloride(0.15 mg/kg)for adjuvant anesthesia and postoperative controlled with intravenous analgesia(PCIA),while the observation group used dexmedetomidine combined with high-dose nalbuphine hydrochloride(0.6 mg/kg)for adjuvant anesthesia and postoperative PCIA.the same dosage of dexmedetomidine were administered in both groups.The anesthetic effects of the two groups were compared.Results:There were no statistically significant differences between two groups in terms of operation duration,extubation duration,anal exhaustion time,length of hospital stay,and blood loss(P>0.05).The total effective rate of anesthesia and postoperative analgesia in the observation group was higher than that in the control group,and the incidence of adverse reactions was lower than that in the control group,with statistically significant differences(P<0.05).Conclusion:The use of dexmedetomidine combined with high-dose nalbuphine hydrochloride for adjuvant anesthesia and postoperative PCIA in patients undergoing laparoscopic radical surgery for colorectal cancer is saft and it contributes to a better effect of anesthesia and postoperative analgesia,