摘要
目的探讨右美托咪定对行气管插管全身麻醉妇科腹腔镜手术患者血流动力学指标、激素水平、血气分析指标的影响。方法选取2016年5月至2019年8月巴彦淖尔市医院收治的87例妇科腹腔镜手术患者作为研究对象,利用随机数字表法将其分为研究组44例和对照组43例。研究组于麻醉诱导前行0.6μg/kg右美托咪定单次静脉注射,对照组给予等量生理氯化钠溶液,之后行气管插管全身麻醉。比较两组血流动力学指标、激素水平及血气分析指标。结果麻醉诱导前,两组心率、平均动脉压比较差异未见统计学意义(P>0.05);气管插管前,两组组内心率、平均动脉压较麻醉诱导前降低,气管插管后即刻升高,气管拔管后10 min又降低,差异均有统计学意义(P均<0.05)。但研究组上述各时间点心率、平均动脉压变化幅度小于对照组,差异有统计学意义(P<0.05)。麻醉前,两组去甲肾上腺素、肾上腺素水平比较差异未见统计学意义(P>0.05),气腹后30 min、解除气腹后5 min,研究组去甲肾上腺素、肾上腺素水平与麻醉前比较差异未见统计学意义(P>0.05),对照组气腹后30 min、解除气腹后5 min,去甲肾上腺素、肾上腺素水平均高于麻醉前(P<0.05)。麻醉前,两组血气分析指标比较差异未见统计学意义(P>0.05),气腹后30 min,研究组动脉血氧分压、动脉血二氧化碳分压、pH值指标较麻醉前变化幅度小于对照组(P<0.05),两组术后30 min血气分析相关指标恢复至麻醉前水平(P>0.05)。结论加用右美托咪定有利于维持气管插管全身麻醉妇科腹腔镜手术患者的生命体征、血气分析指标及激素分泌的稳定。
Objective To investigate the effects of dexmetomidine on hemodynamic indexes,hormone levels and blood gas analysis indexes in gynecological laparoscopic surgery with general anesthesia by endotracheal intubation.Methods Eighty-seven patients who underwent gynecological laparoscopic surgery in Bayannur Hospital from May 2016 to August 2019 were enrolled as the research subjects.And they were divided into the control group(43 cases)and study group(44 cases)by random number table method.Before anesthesia,0.6μg/kg dexmetomidine was injected intravenously into patients in the study group,and the control group was given the same dose of normal saline.Then,both groups were given general anesthesia by endotracheal intubation.The hemodynamic indexes,hormone levels and gas blood analysis indexes were recorded and compared between the two groups.Results Before anesthesia,there was no significant difference in the heart rate(HR)or mean artery pressure(MAP)between the study group and control group(P>0.05);however,the HR and MAP of the two groups decreased prior to intubation,and increased immediately after intubation,then decreased again after extubation,and the differences were all significant(all P<0.05).Moreover,the changes in the two indexes at any time points in study group were smaller than those in control group(P<0.05).Before anesthesia,there was no significant difference in the levels of noradrenaline or adrenaline epinephrine between the two groups(P>0.05).At 30 min after establishment of pneumoperitoneum and 5 min after withdrawal,the levels of noradrenaline and adrenaline epinephrine did not change significantly in study group(P>0.05),but they significantly increased in control group(P<0.05).Before anesthesia,there was no significant difference in blood analysis indexes between the two groups(P>0.05).At 30 min after establishment of pneumoperitoneum,the difference in arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide and pH value in study group were smaller than those in control group(P<0.05);however,at 30 min after treatment,they recovered to the primary levels recorded prior to anesthesia(P>0.05).Conclusions Adding dexmetomidine in general anesthesia by endotracheal intubation is conductive to maintaining the vital signs,blood gas analysis indexes and hormone secretion stability of patients undergoing gynecological laparoscopic surgery.
作者
饶孔
徐瑞
Rao Kong;Xu Rui(Department of Aesthesiology,Bayannur Hospital,Bayannur 015000,China)
出处
《中国实用医刊》
2020年第7期65-68,共4页
Chinese Journal of Practical Medicine
关键词
右美托咪定
妇科腹腔镜手术
气管插管全身麻醉
血流动力学
血气状态
Dexmetomidine
Gynecological laparoscopic surgery
Endotracheal intubation general anesthesia
Hemodynamics
Blood gas status
