右美托咪定辅助麻醉对子宫肌瘤腹腔镜手术患者应激反应及苏醒期躁动的影响

Effect of Dexmedetomidine assisted anesthesia on stress response and emergence agitation in patients undergoing laparoscopic surgery for uterine fibroids

目的 探讨右美托咪定辅助麻醉对子宫肌瘤腹腔镜手术患者应激反应及苏醒期躁动的影响。方法 选择2021年1月至2022年1月宜春市妇幼保健院收治的62例子宫肌瘤患者作为研究对象,依据随机数字表法分为观察组(n=31)与对照组(n=31)。对照组行常规全身麻醉,观察组在对照组的基础上加用右美托咪定。比较两组患者的肾上腺素(NE)、皮质醇(Cor)、苏醒期躁动、血流动力学及安全性。结果 两组患者麻醉前的NE、Cor水平比较,差异无统计学意义(P>0.05);对照组插管后、术毕时、术后1 d的NE、Cor水平均高于本组术前,且对照组插管后、术毕时、术后1 d的NE、Cor水平均高于观察组,差异有统计学意义(P<0.05)。观察组苏醒期躁动程度轻于对照组,差异有统计学意义(P<0.05)。两组术前的舒张压、收缩压及心率比较,差异无统计学意义(P>0.05);对照组术中30 min、术后24 h舒张压、收缩压及心率高于术前,且观察组术中30 min、术后24 h的舒张压、收缩压及心率低于对照组,差异有统计学意义(P<0.05)。观察组的不良反应总发生率为6.45%(2/31),低于对照组的29.03%(9/31),差异有统计学意义(P<0.05)。结论 右美托咪定辅助麻醉对子宫肌瘤腹腔镜手术患者效果较好,能够减轻应激反应,维持血流动力学稳定,降低苏醒期躁动发生,且安全性理想,值得推广应用。

Objective To investigate the effect of dexmedetomidine assisted anesthesia on stress response and emergence agitation in patients undergoing laparoscopic surgery for uterine fibroids.Methods A total of 62 patients with uterine fibroids admitted to Yichun Maternal and Child Health Care Hospital from January 2021 to January 2022 were selected as the research objects.According to the random number table method,they were divided into observation group(n=31) and control group(n=31).The control group was given routine general anesthesia,and the observation group was given Dexmedetomidine on the basis of the control group.The norepinephrine(NE),cortisol(Cor),restlessness during recovery,hemodynamics and safety were compared between the two groups.Results There were no statistically significant differences in NE and Cor levels between the two groups before anesthesia(P>0.05).The levels of NE and Cor in the control group after intubation,at the end of operation and 1 day after operation were higher than those before operation,and the levels of NE and Cor in the control group after intubation,at the end of operation and 1 day after operation were higher than those in the observation group,and the differences were statistically significant(P<0.05).The degree of agitation in the observation group was lighter than that in the control group during the recovery period,and the difference was statistically significant(P<0.05).There were no significant differences in diastolic blood pressure,systolic blood pressure and heart rate between the two groups before operation(P>0.05).The diastolic blood pressure,systolic blood pressure and heart rate 30 min during operation and 24 h after operation in the control group were higher than those before operation,and the diastolic blood pressure,systolic blood pressure and heart rate 30 min during operation and 24 h after operation in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 6.45%(2/31),which was lower than 29.03%(9/31) in the control group,and the difference was statistically significant(P<0.05).Conclusions Dexmedetomidine assisted anesthesia has a good effect on patients undergoing laparoscopic surgery for uterine fibroids,which can reduce stress response,maintain hemodynamic stability,reduce the occurrence of restlessness during recovery,and has ideal safety,which is worthy of promotion and application.