不同剂量右美托咪定对子宫肌瘤腹腔镜下子宫切除患者麻醉药物的镇静和镇痛效果的影响  

Impact of different doses of dexmedetomidine on the anesthetic sedative and analgesic effect of anesthesia agents in hysterectomy of patients with uterine fibroids under laparoscopy

作　　者：廖亿粦[1] 钟瑜婷[1] 邓靖单 林跃华[1] 黄典[1] 

机构地区：[1]梅州市人民医院麻醉科,广东省梅州514031

出　　处：《中国基层医药》2017年第17期2659-2663,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨不同剂量右美托咪定对子宫肌瘤腹腔镜下子宫切除患者麻醉药物的镇静和镇痛效果的影响.方法 选取择期行全身静脉麻醉下腹腔镜子宫切除术、ASA分级Ⅰ或Ⅱ级子宫肌瘤患者90例,按随机数字表法分A组（右美托咪定0.4 μg·kg^-1·h^-1,n=30）、B组（右美托咪定0.2 μg·kg^-1·h^-1,n=30）和C组（未用药,n=30）.比较A组、B组和C组术前和术后1 h、12 h和24 h的镇痛（VAS评分）效果和镇静（Ramsay镇静评分）,比较三组一般资料、术后血压、脉搏氧饱和度和心率等、以及术后患者对镇痛效果和镇静效果的满意度及不良反应.结果 三组在年龄、体质量指数等基本资料差异均无统计学意义（均P＞0.05）,三组术前VAS评分差异无统计学意义（F=0.625,P＞0.05）,A组和B组术后12 h、24 h的VAS评分低于C组,A组术后12 h、24 h的VAS评分低于B组（F=11.250,P＜0.05;F=21.181,P＜0.05）.Ramsay镇静评分则高于C组[（3.67±0.18）比（2.13±0.11）],满意度A组明显高于B组和C组（96.67％比73.33％、46.67％,χ2=25.953）,Ramsay镇静评分和满意度则均高于B组（均P＜0.05）.三组术后患者术前和术后的血压（F=0.362,P＞0.05）、脉搏氧饱和度（F=0.978,P＞0.05）和心率差异无统计学意义（F=1.268,P＞0.05）.三组均无明显不良反应的发生.结论 右美托咪定对可促进子宫肌瘤腹腔镜下子宫切除患者麻醉药物的镇静和镇痛作用,其中以0.4 μg·kg^-1·h^-1剂量的右美托咪定可取得更好的效果,具有良好的可行性和安全性,值得临床推广使用.Objective To explore the impact of different doses of dexmedetomidine on the anesthetic sedative and analgesic effect of anesthesia agents in hysterectomy of patients with uterine fibroids under laparoscopy.Methods 90 patients with uterine fibroids with ASA class Ⅰ or Ⅱ who were going to undergoing general intravenous anesthesia laparoscopic hysterectomy were selected and they were divided into group A （dexmedetomidine 0.4μg·kg^-1·h^-1,n=30） and group B （dexmedetomidine 0.2μg·kg^-1·h^-1,n=30） and group C （no dexmedetomidine,n=30） by digital random method.The analgesia effect （VAS score） of group A,group B and group C preoperation and postoperative 1h,12h and 24h,and the sedation （Ramsay sedation score） were compared.General information,postoperative blood pressure,heart rate,pulse oxygen saturation,postoperative patients＇satisfaction on analgesic effect and the sedation effect and adverse reactions of the three groups were also compared.Results Age,body mass index and other basic information of three groups had no statistically significant differences （all P〉0.05）.The preoperative VAS score of the three groups also had no statistically significant difference （F=0.625,P〉0.05）.Postoperative 12h,24h,the VAS scores of group A and group B were lower than those of C group,which of group A were lower than group B （F=11.250,P〈0.05,F=21.181,P〈0.05）.The Ramsay sedation score was higher than that of C group[（3.67±0.18） vs.（2.13±0.11）].The satisfaction of group A was significantly higher than group B and group C （96.67% vs.73.33%,46.67%,χ2=25.953）.The Ramsay sedation score and satisfaction were higher than those of group B （all P〈0.05）.There were no significant differences in blood pressure （F=0.362,P〉0.05）,pulse oxygen saturation （F=0.978,P〉0.05） and heart rate among the three groups before and after operation （F=1.268,P〉0.05）.There was no obvious adverse reaction in the three groups.Conclusion Dexmedetomidine can promote anesthetic s

关 键 词：右美托咪定 子宫肌瘤 腹腔镜检查 子宫切除术 镇痛 

分 类 号：R614[医药卫生—麻醉学] R737.33[医药卫生—外科学]