不同剂量右美托咪啶用于腹腔镜妇科手术的有效性和安全性探讨  

To Investigate the Efficacy and Safety of Dexmedetomidine with Different doses in Laparoscopic Gynecological Surgery

作　　者：佟泉威 TONG Quanwei(Dandong Central Hospital,Dandong 118000,China)

机构地区：[1]丹东市中心医院,辽宁丹东118000

出　　处：《中国医药指南》2023年第10期96-98,共3页Guide of China Medicine

摘　　要：目的分析不同剂量右美托咪定在腹腔镜妇科手术中的应用效果。方法本研究50例腹腔镜妇科手术患者均为本院2019年1月至2019年12月接收,根据右美托咪定不同剂量分为两组,对照组(25例)麻醉诱导前10 min予以0.2μg/kg右美托咪定,观察组麻醉诱导前10 min予以0.5μg/kg右美托咪定,主要方法为做好术前准备,包括禁食,禁水,术前30 min为患者肌内注射阿托品,开放静脉通道。麻醉诱导前注射0.5μg/kg右美托咪定,麻醉诱导过程中,两组均采取丙泊酚2 mg/kg、地塞米松10 mg、维库溴铵0.1 mg/kg、咪达唑仑0.05 mg/kg和舒芬太尼3μg/kg维持麻醉,待气管插管完成后,给予患者机械通气。手术过程中,为患者泵注瑞芬太尼和少量丙泊酚,定期为患者注射维库溴铵,监测患者各项生命体征,观察期有无出现不良反应等,对不同时间点MAP、HR以及术后并发症进行比较。结果T2至T4时刻,观察组MAP水平比对照组低,差异显著(P<0.05);T2至T3时刻,观察组HR比对照组低,差异明显(P<0.05);观察组镇静评分、苏醒期躁动评分、认知功能评分、寒战评分以及不良反应发生率均对照组更优,差异明显(P<0.05)。结论右美托咪定是当下临床常见麻醉药物,能够发挥出显著的麻醉功效和镇痛功效。妇科腹腔镜手术期间,高剂量右美托咪定有助于手术期间维持患者血流动力学稳定,确保手术顺利进行,而且安全性更高,同时能够减少术后并发症。Objective To analyze the effect of dexmedetomidine in different doses in laparoscopic gynecological surgery.Methods In this study,50 patients receiving laparoscopic gynecological surgery from January 2019 to December 2019 were divided into two groups according to different doses of dexmedetomidine.The control group(25 cases)was given 0.2μg/kg dexmedetomidine 10 minutes before anesthesia induction,and the observation group was given 0.5μg/kg dexmedetomidine 10 minutes before anesthesia induction.The main methods were preoperative preparation,including fasting,water prohibition,intramuscular injection of atropine 30 minutes before surgery,and opening of venous channels.Before anesthesia induction,0.5μg/kg dexmedetomidine was injected,and during anesthesia induction,2 mg/kg,10 mg dexamethasone,0.1 mg/kg vicuronium bromide,0.05 mg/kg midazolam and 3μg/kg sufentanil were administered in both groups to maintain anesthesia.After endotracranial intubation was completed,patients were given mechanical ventilation.During the operation,patients were injected with remifentanil and a small amount of propofol,and vicurium bromide was injected regularly.Vital signs of patients were monitored,and whether there were adverse reactions during the observation period.MAP,HR,and postoperative complications were compared at different time points.Results From T2 to T4,MAP level in the observation group was lower than that in the control group,and the difference was significant(P<0.05).From T2 to T3,HR in observation group was lower than that in control group,and the difference was significant(P<0.05).The sedation score,waking agitation score,cognitive function score and chills score and the adverse reactions of the observation group were all better than those of the control group(P<0.05).Conclusion Dexmedetomidine is a common anesthetic drug in clinical practice,which can play a significant role in anesthesia and analgesia.During gynecological laparoscopic surgery,high doses of dexmedetomidine help maintain hemodynamic stability of p

关 键 词：腹腔镜 妇科手术 右美托咪定 

分 类 号：R614[医药卫生—麻醉学]