摘要
目的:探讨腹腔镜全子宫切除术单次注射右美托咪定(Dex)对患者镇静-觉醒评分(OAA/S)及苏醒期躁动的影响.方法:选取2018年1月-2021年12月在本院行腹腔镜全子宫切除术患者70例,随机数字表法分为3组,对照组(n=23)常规全麻,Dex持续泵注组(n=23)麻醉诱导前15min持续泵注Dex0.3μg/kg/h至手术结束前20min,Dex单次注射组(n=24)麻醉诱导前单次静脉注射Dex0.6μg/kg.对比3组心率(HR)、平均动脉压(MAP)、OAA/S评分、苏醒期不良反应、拔管时间、定向力恢复时间、麻醉恢复室停留时间.结果:T_(1)(腹压达10mmHg后即刻)、T_(2)(5min)、T_(3)(10min)、T_(4)(20min)、T_(5)(40min)T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时,HR水平Dex持续泵注组、对照组的均高于T0(气腹建立前),且Dex单次注射组、Dex持续泵注组、对照组依次升高(均P<0.05);T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时,MAP水平3组均高于T0,且Dex单次注射组、Dex持续泵注组、对照组依次升高(均P<0.05).Dex单次注射组、Dex持续泵注组的OAA/S评分分级情况均优于对照组(P<0.05);Dex单次注射组的苏醒期不良反应总发生率(8.3%)低于Dex持续泵注组(39.1%)、对照组(56.5%),拔管时间(14.02±2.54min)、定向力恢复时间(18.24±6.05min)、麻醉恢复室停留时间(22.56±7.48min)均短于Dex持续泵注组(23.12±3.05min、24.75±8.19 min、26.84±8.89 min)、对照组(19.33±2.86min、20.18±6.67min、34.37±11.13min)(均P<0.05).结论:单次注射Dex用于腹腔镜全子宫切除术的麻醉效果较好,且能稳定血流动力学指标,缩短麻醉恢复时间,提高麻醉苏醒期质量,减少苏醒期不良反应发生.
Objective: To investigate the effects of single injection of dexmedetomidine(Dex)during laparoscopic hysterectomy of patients on their observer's assessment of alertness/sedation(OAA/S)score and their restlessness in recovery period.Methods:70 patients who wanted laparoscopic hysterectomy were selected and were divided into three groups by random number table from January 2018 to December 2021.23 patients in group A were given continuous pump injection of Dex 0.3μg/(kg·h)from 15 minutes before induction of anesthesia to 20 minutes at the end of the operation,24 patients in group B were given single intravenous injection of Dex 0.6μg/kg before induction of anesthesia,and 23 patients in group C were given conventional general anesthesia.The heart rate(HR),mean arterial pressure(MAP),OAA/S score,rate of adverse reactions during recovery period,extubation time,orientation recovery time,and staying time in the anesthesia recovery room of the patients were compared among the three groups.Results:The HR value of the patients in group A and group C at T_(1)(immediately after abdominal pressure reached 10mmHg),T_(2)(5min),T_(3)(10min),T_(4)(20min),and T_(5)(40min)were significantly higher than those at T0(before pneumoperitoneum establishment).The HR value of the patients in group B,group A,and group C at T0,T_(1),T_(2),T_(3),T_(4) and T_(5) had increased gradually(all P<0.05).The MAP value of the patients in the three groups at T_(1),T_(2),T_(3),T_(4),and T_(5) was significantly higher than that of the patients at T0.The MAP value of the patients in group B,group A,and group C at T0,T_(1),T_(2),T_(3),T_(4),and T_(5) had increased gradually(all P<0.05).The score of OAA/S of the patients in group B or group A was significantly better than that of the patients in group C(P<0.05).The total incidence of adverse reaction(8.3%)of the patients in group B was significantly lower than that(39.1%)of the patients in group A or that(56.5%)of the patients in group C.The extubation time(14.02±2.54 min),the directional force recovery time(18.24±6.05 min),and the stay time in anesthesia recovery room(22.56±7.48 min)of the patients in group B were significantly shorter than those(23.12±3.05 min,24.75±8.19 min,26.84±8.89 min)of the patients in group A or those(19.33±2.86 min,20.18±6.67 min,34.37±11.13 min)of the patients in group C(all P<0.05).Conclusion:Single injection of Dex during laparoscopic total hysterectomy of the patients has better anesthetic effect,which can stabilize their hemodynamic indicators,shorten their recovery time of anesthesia,improve their quality during anesthesia recovery period,and reduce their occurrence of adverse reactions during the recovery period.
作者
缪兰芬
顾玲玲
MIAO Lanfen;GU Lingling(Jiangsu Shengze Hospital Affiliated to Nanjing Medical University,Jiangsu Province,215228)
出处
《中国计划生育学杂志》
2022年第10期2233-2237,共5页
Chinese Journal of Family Planning
关键词
腹腔镜全子宫切除术
右美托咪定
单次注射
镇静-觉醒评分
苏醒期躁动
麻醉恢复
不良反应
Laparoscopic total hysterectomy
Dexmedetomidine
Single injection
Observer's assessment of alertness/sedation
Restlessness during recovery
Anesthesia recovery
Adverse reactions
