小剂量右美托咪定在腹腔镜下子宫肌瘤切除术中的应用价值  

The Application Value of low-dose Dexmedetomidine in laparoscopic Myomectomy

作　　者：方永红 张波涛 张春燕[2] FANG Yonghong;ZHANG Botao;ZHANG Chunyan(Department of Anesthesia,Xihua County Maternal and Child Health Hospital,Zhoukou Henan 466600,China;Department of Anesthesia,Zhoukou Central Hospital,Zhoukou Henan 466000,China)

机构地区：[1]西华县妇幼保健院麻醉科,河南周口466600 [2]周口市中心医院麻醉科,河南周口466000

出　　处：《临床研究》2023年第9期78-81,共4页Clinical Research

摘　　要：目的分析小剂量右美托咪定在腹腔镜下子宫肌瘤切除术中的价值。方法选择2020年3月至2022年12月来西华县妇幼保健院行腹腔镜下子宫肌瘤切除术的112例患者,依据信封法分为对照组和观察组,对照组55例采用环泊酚麻醉,观察组57例在对照组基础上给予小剂量右美托咪定麻醉。比较两组血流动力学、褪黑素、术后恢复情况、视觉模拟(VAS)评分、简易精神状态检查量表评分(MMSE)、地佐辛用量、不良反应发生率。结果切皮时对照组平均动脉压(MAP)升高,差异有统计学意义(P<0.05),剔除肌瘤时两组MAP升高,差异有统计学意义(P<0.05),观察组切皮时、剔除肌瘤时MAP低于对照组,差异有统计学意义(P<0.05),对照组切皮时、剔除肌瘤时、术毕心率(HR)上升,差异有统计学意义(P<0.05),观察组切皮时、剔除肌瘤时及术毕HR低于对照组,差异有统计学意义(P<0.05);麻醉30 min、苏醒后两组褪黑素降低且观察组高于对照组,差异有统计学意义(P<0.05);两组拔管时间、麻醉苏醒时间、应答时间及术后住院时间比较,差异无统计学意义(P>0.05);术后6 h、术后12 h、术后24 h观察组VAS评分低于对照组,差异有统计学意义(P<0.05),术后6 h、术后12 h、术后24 h观察组MMSE评分高于对照组,差异有统计学意义(P<0.05);观察组术后第1天、术后第2天补救镇痛药用量少于对照组,差异有统计学意义(P<0.05);两组头晕、心房颤动、低血压、心动过缓及注射痛不良反应发生率比较,差异无统计学意义(P>0.05)。结论小剂量右美托咪定应用于腹腔镜下子宫肌瘤切除术中,患者血流动力学更稳定,镇静、镇痛效果更好,对患者认知功能影响更小。Objective To analyze the value of low-dose dexmedetomidine in laparoscopic myomectomy.Method A total of 112 patients who underwent laparoscopic myomectomy in our hospital from March 2020 to December 2022 were selected and divided into a control group and an observation group based on the envelope method.The control group consisted of 55 patients who were anesthetized with ciprofol,while the observation group consisted of 57 patients who received a small dose of dexmedetomidine anesthesia on top of the control group.the hemodynamics,melatonin,postoperative recovery,visual analogue(VAS)score,simplified mental state examination scale score(MMSE),dosage of dexamethasone,and incidence of adverse reactions between the two groups were compared.Results The mean arterial pressure(MAP)of the control group increased significantly during skin removal,with a statistically significant difference(P<0.05),and the MAP of the two groups increased significantly after removing fibroids,with a statistically significant difference(P<0.05).The heart rate(HR)of the control group increased significantly during skin removal and fibroids removal,and the difference was statistically significant(P<0.05).The MAP of the observation group was lower than that of the control group during skin removal and fibroids removal,and the difference was statistically significant(P<0.05).After 30 minutes of anesthesia and awakening,melatonin levels in the two groups decreased and the observation group was higher than the control group,with a statistically significant difference(P<0.05);There was no statistically significant difference in extubation time,anesthesia recovery time,response time,and postoperative hospitalization time between the two groups(P>0.05);The VAS score of the observation group at 6 hours,12 hours,and 24 hours after surgery was lower than that of the control group,with a statistically significant difference(P<0.05).The MMSE score of the observation group at 6 hours,12 hours,and 24 hours after surgery was higher than that of the control

关 键 词：右美托咪定 环泊酚 子宫肌瘤切除术 血流动力学 褪黑素 术后恢复 

分 类 号：R614[医药卫生—麻醉学]