右美托咪定复合腰硬联合麻醉对腹腔镜卵巢囊肿手术的影响  

Effect of dexmedetomidine combined with spinal-epidural anesthesia on laparoscopic ovarian cyst surgery

作　　者：王军 廖伟芋 王晓旭 赵启兵 Wang Jun;Liao Weiyu;Wang Xiaoxu;Zhao Qibing(Department of Surgical Anesthesia,Ankang People's Hospital,Ankang 725000,China;Department of Anesthesiology,Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,China;Laboratory Medicine Department,Ankang People's Hospital,Ankang 725000,China)

机构地区：[1]安康市人民医院手术麻醉科,安康725000 [2]安康市中医医院麻醉科,安康725000 [3]安康市人民医院检验科,安康725000

出　　处：《国际医药卫生导报》2024年第7期1104-1110,共7页International Medicine and Health Guidance News

基　　金：陕西省自然科学基础研究资助项目(2022JM-570)。

摘　　要：目的探讨右美托咪定复合腰硬联合麻醉对腹腔镜卵巢囊肿手术的麻醉效果及对认知功能、应激反应的影响。方法前瞻性选取2020年1月至2023年8月安康市人民医院收治的108例卵巢囊肿患者,采用随机数字表法分为对照组和研究组,每组54例。对照组年龄(49.85±5.68)岁,体质量指数(23.01±1.59)kg/m^(2),病程(4.62±0.71)年,美国麻醉医师协会(ASA)Ⅰ级20例,Ⅱ级34例;研究组年龄(51.05±6.23)岁,体质量指数(23.18±1.47)kg/m^(2),病程(4.79±0.76)年,ASAⅠ级18例,Ⅱ级36例。对照组给予咪达唑仑复合腰硬联合麻醉,研究组给予右美托咪定复合腰硬联合麻醉。对比两组围手术期血流动力学、术中寒颤、疼痛、认知功能、应激反应、炎症反应及不良反应情况。采用t检验、LSD-t检验和χ^(2)检验进行统计比较。结果麻醉诱导前(T0)、切皮时(T1)、麻醉30 min(T2)、术毕(T3)时,研究组平均动脉压分别为(93.02±5.97)mmHg(1 mmHg=0.133 kPa)、(81.03±4.86)mmHg、(84.51±6.24)mmHg、(86.12±4.05)mmHg,心率分别为(83.73±5.16)次/min、(68.76±4.16)次/min、(74.31±4.13)次/min、(76.02±4.84)次/min;对照组分别为(94.16±6.08)mmHg、(84.58±5.12)mmHg、(83.67±5.73)mmHg、(89.73±4.14)mmHg,(84.59±5.01)次/min、(72.32±4.85)次/min、(76.85±4.26)次/min、(79.88±5.01)次/min;两组不同时间点间的平均动脉压、心率差异均有统计学意义(F=9.143、8.769,均P<0.001),两组平均动脉压、心率差异均有统计学意义(F=8.371、8.416,均P<0.001),两组平均动脉压、心率变化趋势差异均有统计学意义(F=9.168、9.316,均P<0.001)。研究组寒颤发生率(5.56%,3/54)低于对照组(18.52%,10/54)(χ^(2)=4.285,P=0.038)。术后4 h、12 h、24 h研究组疼痛视觉模拟量表(VAS)评分分别为(2.17±0.36)分、(3.07±0.38)分、(2.45±0.41)分,对照组分别为(2.21±0.39)分、(3.38±0.42)分、(2.69±0.43)分;不同时间点间的VAS评分差异有统计学意义(F=9.054,P<0.001),两组VAS评分差异�Objective To investigate the anesthetic effect of dexmedetomidine combined with lumbar epidural anesthesia on laparoscopic ovarian cyst surgery and its influence on cognitive function and stress response.Methods A total of 108 patients with ovarian cysts admitted to Ankang People's Hospital from January 2020 to August 2023 were selected,and were divided into a control group and a study group by the random number table method,with 54 cases in each group.The control group were(49.85±5.68)years old,with a body mass index of(23.01±1.59)kg/m^(2) and a disease course of(4.62±0.71)years.There were 20 cases of gradeⅠand 34 cases of gradeⅡof American Society of Anesthesiologists(ASA)in the control group.The study group were(51.05±6.23)years old,with a body mass index of(23.18±1.47)kg/m^(2) and a disease course of(4.79±0.76)years;there were 18 cases of gradeⅠand 36 cases of gradeⅡof ASA in the study group.The control group were given midazolam and combined spinal-epidural anesthesia,and the study group dexmedetomidine and combined spinal-epidural anesthesia.The perioperative hemodynamics,intraoperative shivering,pain,cognitive function,stress response,inflammatory response,and adverse reactions were compared between the two groups using t,LSD-t,and χ^(2) tests.Results The mean arterial pressures and heart rates before anesthesia induction(T0),at skin incision(T1),anesthesia for half an hour(T2),and at the end of operation(T3)were(93.02±5.97)mmHg(1 mmHg=0.133 kPa),(81.03±4.86)mmHg,(84.51±6.24)mmHg,and(86.12±4.05)mmHg and(83.73±5.16)times/min,(68.76±4.16)beats/min,(74.31±4.13)beats/min,and(76.02±4.84)beats/min in the study group,and were(94.16±6.08)mmHg,(84.58±5.12)mmHg,(83.67±5.73)mmHg,and(89.73±4.14)mmHg and(84.59±5.01)beats/min,(72.32±4.85)beats/min,(76.85±4.26)beats/min,and(79.88±5.01)beats/min in the control group;there were statistical differences in the mean arterial pressure and heart rate between different time points in both group(F=9.143 and 8.769;both P<0.001);there were statistical

关 键 词：右美托咪定 腰硬联合麻醉 腹腔镜 卵巢囊肿手术 效果 

分 类 号：R614[医药卫生—麻醉学] R737.31[医药卫生—外科学]