右美托咪定静脉泵注联合七氟烷吸入诱导在宫腔镜手术麻醉中的应用效果

Analysis of the application effect of dexmedetomidine vein pump injection combined with sevoflurane inhalation induction in hysteroscopic surgery anesthesia

目的:分析右美托咪定静脉泵注联合七氟烷吸入诱导在宫腔镜手术麻醉中的应用效果。方法:2013年1-12月收治宫腔镜手术麻醉患者90例,并将其随机分为A、B、C 3组。A组麻醉诱导前15 min静脉泵注0.5μg/kg右美托咪定,B组麻醉诱导前15 min静脉泵注1.0μg/kg右美托咪定,C组麻醉诱导前15 min泵注生理盐水10 m L,3组患者均联合七氟烷吸入诱导。时机适当后为患者置入喉罩,并在自主呼吸状态下为患者连接麻醉机SIMV模式,以2%~3%七氟烷持续吸入麻醉。密切监测患者对七氟烷吸入的适应情况。同时,对患者静脉泵注右美托咪定前(T0)、后5min(T1),麻醉诱导后意识消失时(T2),置入喉管后1 min(T3)、3 min(T4)时的体征进行监测。结果:A、B两组患者在T1时间出现心率(HR)下降情况,C组患者于T2时间平均动脉压(MAP)下降,与诱导前差异存在统计学意义(P<0.05)。A、B、C 3组患者置入喉罩前后的HR与MAP差异无统计学意义(P>0.05)。结论:麻醉诱导前15 min静脉泵注0.5μg/kg右美托咪定联合七氟烷吸入诱导在宫腔镜手术麻醉中具有较好的效果,其可使患者在自主呼吸的状态下顺利置入喉罩,麻醉效果较好。

Objective:To analyze the application effect of dexmedetomidine vein pump injection combined with sevoflurane inhalation induction in hysteroscopic surgery anesthesia.Methods:90 patients with hysteroscopic surgery anesthesia were selected from January to December 2013.They were randomly divided into A,B,C 3 groups.A group was given vein pump injection of 0.5 μg/kg dexmedetomidine at 15 minutes before anesthesia induction;B group was given vein pump injection of 1.0 μ g/kg dexmedetomidine at 15 minutes before anesthesia induction;C group was given pump injection of 10 mL normal saline at 15 minutes before anesthesia induction.The patients in 3 groups were combined with sevoflurane inhalation induction.The patients were placed laryngeal mask after the time appropriate,and the patients were connected anaesthesia machine SIMV pattern under the spontaneous breathing condition with 2% ~3% sevoflurane continue inhalation anesthesia.The adaptation condition of sevoflurane inhalation of patients was closely monitored.At the same time,the physical signs of patietns were monitored before vein pump injection of dexmedetomidine (T0),later 5 minutes(T1),consciousness disappears after anesthesia induction(T2),1 minute after placing laryngeal mask(T3),3 minutes(T4).Results:The patients in A,B two groups appeared heart rate(HR) decline at T1 time,the patients in C group appeared mean arterial pressure(MAP) decline at T2 time,and there was significant difference with before induction(P<0.05).There were no significant differences between HR and MAP of the patients in A,B,C 3 groups before and after placing laryngeal mask(P>0.05).Conclusion:Vein pump injection of 0.5 μg/kg dexmedetomidine at 15 minutes before anesthesia induction combined with sevoflurane inhalation induction have better effect in hysteroscopic surgery anesthesia.It could make patients with smoothly placing laryngeal mask in spontaneously breathing,its anesthetic effect is better.