不同剂量右美托咪定麻醉对卵巢癌手术患者临床疗效的研究  

Clinical effects of different doses of dexmedetomidine anesthesia on patients undergoing ovarian cancer surgery

作　　者：王玥[1] 康凯[1] 白云波[1] 曹文超 韩斌[1] WANG Yue;KANG Kai;BAI Yunbo;CAO Wenchao;HAN Bin(Department of Anesthesiology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院麻醉科,北京100026

出　　处：《中国妇幼健康研究》2021年第7期1047-1050,共4页Chinese Journal of Woman and Child Health Research

基　　金：北京市卫生与健康科技成果推广项目(编号:2018-TG-21)。

摘　　要：目的探讨卵巢癌手术患者在不同剂量右美托咪啶麻醉下的临床效果以及术后患者苏醒后疼痛情况。方法选择2019年4月至2020年8月首都医科大学附属北京妇产医院150名卵巢癌手术患者为研究对象,按照数学法随机分为A组、B组和C组,每组各50例,三组患者均使用0.3μg/kg舒芬太尼、1.5%3%七氟醚、0.1μg/(kg·min)瑞芬太尼进行麻醉诱导和维持。诱导麻醉后的15min内,A组患者将0.2μg/kg右美托咪定、B组患者将0.4μg/kg右美托咪定、对照组将0.9%的氯化钠推注入静脉。取诱导麻醉后未给药(T0)、手术结束(T1)以及拔管后15min(T2)作为检测点,记录这三个时间点的心率(HR)、收缩压(SBP)和舒张压数值(DBP),观察三组患者麻醉苏醒期间,并进行苏醒躁动程度评分(RS)和拔管后3h、6h、12h、24h的疼痛视觉评分(VAS),同时监测拔管后患者的临床反应。结果三组患者T2时间点HR、SBP和DBP比较差异有统计学意义(F值分别为2.998、2.578、2.469,P<0.05),进一步每两组间比较结果显示C组患者T2时间点上述指标均显著高于A组和B组(t值2.4792.998,P<0.05)。C组患者不同时间点HR、SBP和DBP比较差异有统计学意义(F值分别为2.564、2.647、2.448,P<0.05),进一步比较不同时间点结果显示T2时间点上述指标均显著高于T0和T1(t值2.4503.012,P<0.05)。而A组和B组不同时间点HR、SBP和DBP比较差异无统计学意义(F值0.0911.014,P>0.05)。三组患者躁动评分及术后不同时间点VAS比较差异有统计学意义(F值分别为2.578、2.678、2.789、2.906、3.012,P<0.05),进一步每两组间比较结果显示C组患者上述指标均显著高于A组和B组患者(t值2.5383.245,P<0.05),B组患者上述指标低于A组患者,但其差异无统计学意义(t值0.2460.897,P>0.05)。结论右美托咪定麻醉对卵巢癌手术患者的镇痛作用能起到积极作用,高剂量者麻醉效果优于低剂量,但差异无统计学意义,尚需进一步研究。Objective To investigate the clinical effects of different doses of dexmedetomidine anesthesia on patients undergoing ovarian cancer surgery,and the pain conditions after recovery of the patients after surgery.Methods A total of 150 patients undergoing ovarian cancer surgery in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from April 2019 to August 2020 were selected as the research objects.They were randomly divided into group A,group B and group C according to mathematical method,with 50 patients in each group.All patients in the three groups were treated with 0.3μg/kg sufentanil,1.5%~3%sevoflurane,and 0.1μg/(kg·min)remifentanil for the induction and maintenance of anesthesia.Within 15 minutes after the induction of anesthesia,0.2μg/kg dexmedetomidine for group A,0.4μg/kg dexmedetomidine for group B,and 0.9%sodium chloride for control group were used by intravenous injection.Setting the conditions of without medicine after induction of anesthesia(T0),end of surgery(T1),and 15 min after extubation(T2)as testing points.The heart rate(HR),systolic blood pressure(SBP),and diastolic blood pressure(DBP)values on the three time points were recorded,and the degree of restlessness score(RS)at recovery and 3 h,6 h,12 h,24 h visual analogue scale(VAS)pain score after extubation were observed in the three groups during anesthesia recovery.At the same time,the clinical response after extubation of patients was monitored.Results There were statistically significant differences in HR,SBP and DBP at T2 time point among the three groups(F=2.998,2.578 and 2.469,respectively,all P<0.05),and the results of further comparisons between every two groups showed that the above indicators at T2 time point in group C were significantly higher than those in group A and group B(t=2.479~2.998,all P<0.05).There were statistically significant differences in HR,SBP and DBP at different time points in group C(F=2.564,2.647 and 2.448,respectively,all P<0.05),and the results of further comparisons between different ti

关 键 词：右美托咪定 麻醉 卵巢癌 镇痛效果 预后 

分 类 号：R713.6[医药卫生—妇产科学] R614[医药卫生—临床医学]