右美托咪定在腰硬联合麻醉子宫肌瘤切除术中的应用效果以及镇痛价值分析

Analysis of practical effect and analgesic value of dexmedetomidine in myomectomy under combined spinal-epidural anesthesia

目的 研究右美托咪定在腰硬联合麻醉子宫肌瘤切除术患者中的应用效果及镇痛价值。方法 76例子宫肌瘤切除术患者,患者均行腰硬联合麻醉,根据麻醉用药差异性分为参照组和镇痛组,每组38例。参照组给予丙泊酚麻醉,镇痛组给予右美托咪定麻醉。比较两组麻醉前、开始手术0.5 h临床指标及镇静效果、不良事件发生率。结果 麻醉前,两组心率、平均动脉压、Ramsay镇静评分、脑电双频指数(BIS)评分比较,差异无统计学意义(P>0.05);开始手术0.5 h,两组心率、平均动脉压、BIS评分低于本组治疗前, Ramsay镇静评分高于本组治疗前,镇痛组心率(70.28±10.26)次/min、平均动脉压(85.13±7.02)mm Hg(1 mm Hg=0.133 kPa)、Ramsay镇静评分(4.59±0.52)分高于参照组的(65.12±10.35)次/min、(78.82±7.64)mm Hg、(2.62±0.18)分, BIS评分(62.91±0.64)分低于参照组的(86.53±1.65)分,差异有统计学意义(P<0.05)。镇痛组镇静总有效率97.37%高于参照组的81.58%,差异有统计学意义(P<0.05)。镇痛组不良事件发生率7.89%低于参照组的26.32%,差异有统计学意义(P<0.05)。结论 右美托咪定用于腰硬联合麻醉子宫肌瘤切除术中可提高镇静效果,稳定血流动力学,值得推崇。

Objective To study the practical effect and analgesic value of dexmedetomidine in myomectomy under combined spinal-epidural anesthesia.Methods A total of 76 patients with myomectomy under combined spinal-epidural anesthesia were divided into a reference group and an analgesia group according to the difference of anesthesia drugs,with 38 cases in each group.The reference group was given propofol anesthesia,and the analgesia group was given dexmedetomidine anesthesia.The clinical indicators and sedation effect before anesthesia and at 0.5 h after the beginning of surgery,and incidence of adverse events were compared between the two groups.Results Before anesthesia,there was no statistically significant difference in heart rate,mean arterial pressure,Ramsay sedation score and bispectral index(BIS)score between the two groups(P>0.05).At 0.5 h after the beginning of surgery,the heart rate,mean arterial pressure and BIS score in both groups were lower than those before treatment in this group,while the Ramsay sedation score was higher than that before treatment in this group;in the analgesia group,the heart rate was(70.28±10.26)beats/min,the mean arterial pressure was(85.13±7.02)mm Hg(1 mm Hg=0.133 kPa)and the Ramsay sedation score was(4.59±0.52)points,which were higher than those of(65.12±10.35)beats/min,(78.82±7.64)mm Hg and(2.62±0.18)points in the reference group;BIS score of(62.91±0.64)points in analgesia group was lower than that of(86.53±1.65)points in the reference group;the differences were statistically significant(P<0.05).The total effective rate of sedation in the analgesia group was 97.37%,which was higher than that of 81.58%in reference group,and the difference was statistically significant(P<0.05).The incidence of adverse events of 7.89%in the analgesia group was lower than that of 26.32%in the reference group,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine can improve sedative effect and stabilize hemodynamics in myomectomy under combined spinal-epidural anesthesia,and is worthy of recommendation.