摘要
目的:探究右美托咪定对全凭静脉麻醉下腹腔镜子宫肌瘤剔除患者手术丙泊酚用量及血流动力学和术后疼痛的影响。方法:选取2020年1月-2023年1月在本院行全凭静脉麻醉(麻醉诱导前静脉输注右美托咪定)下腹腔镜子宫肌瘤剔除手术患者45例为观察组,按1:1比例选取同期本院行全凭静脉麻醉(麻醉诱导前不做特殊处理)下腹腔镜子宫肌瘤剔除手术患者45例为对照组,比较两组麻醉前、气管插管前、气腹即刻、气腹后后30 min、手术结束(T0~T4)时丙泊酚用量、血流动力学以及术后2 h、12 h、24 h疼痛情况、不良反应。结果:T1~T4时观察组丙泊酚血浆靶浓度分别为(3.06±0.68μg/ml、2.87±0.72μg/ml、3.24±0.87μg/ml、0.86±0.21μg/ml)均低于对照组(3.62±0.93μg/ml、3.53±1.12μg/ml、4.06±1.22μg/ml、1.51±0.37μg/ml)(均P<0.05);T0时,两组HR、MAP比较无差异(P>0.05);T1~T4时,观察组HR、MAP均低于对照组(均P<0.05);与T0时比较,对照组T1~T4时HR、MAP均上升,观察组T1~T4时HR下降,T3时MAP上升(均P<0.05)。术后2 h、12 h、24 h观察组疼痛程度评分(2.16±0.45分、2.76±0.64分、2.36±0.42分)均低于对照组(3.56±1.10分、4.75±1.26分、3.51±1.03分)(均P<0.05);不良反应总发生率观察组与对照组(20.0%、26.7%)无差异(P>0.05)。结论:右美托咪定应用于全凭静脉麻醉下腹腔镜子宫肌瘤剔除、术可减少术中丙泊酚用量,稳定患者血流动力学,缓解患者术后疼痛,未增加用药不良反应。
Objective:To explore the effects of dexmedetomidine(DEX)used in total intravenous anesthesia of patients during laparoscopic myomectomy on their propofol dosage,hemodynamics and postoperative pain.Methods:From January 2020 to January 2023,45 patients who had received the laparoscopic myomectomy under total intravenous anesthesia(patients with intravenous infusion of DEX before anesthesia induction)in the hospital were selected in the observation group retrospectively,and 45 patients in the control group had received the laparoscopic myomectomy under total intravenous anesthesia(patients without the special treatment before anesthesia induction)during the same period were included in control group according to the ratio of 1:1.The dosage of propofol and the hemodynamics before anesthesia(T0),before tracheal intubation(T1),immediately after pneumoperitoneum(T2),at 30 min after pneumoperitoneum(T3)and at the end of surgery(T4),the pain status at 2 h,12 h and 24 h after surgery and the adverse reactions rate of the patients were compared between the two groups.Results:The plasma target concentration of propofol of the patients in the observation group at T1 to T4 were 3.06±0.68μg/ml,2.87±0.72μg/ml,3.24±0.87μg/ml and 0.86±0.21μg/ml,respectively,and which were significantly lower than those(3.62±0.93μg/ml,3.53±1.12μg/ml,4.06±1.22μg/ml and 1.51±0.37μg/ml)of the patients in the control group(all P<0.05).At T0,there were no significant differences in the HR and MAP values of the patients between the two groups(P>0.05).At T1 to T4,the values of HR and MAP of the patients in the observation group were significantly lower than those of the patients in the control group(all P<0.05).The values of HR and MAP of the patients in the control group at T1 to T4 were significantly higher than those at T0,while which of the patients in the observation group at T1 to T4 were significantly lower than those at T0.The HR value of the patients in the observation group at T1 to T4 was significantly lower than that at T0,while the MAP value of the patients in the observation group at T3 were significantly higher than that at T0(all P<0.05).The pain degree scores of the patients in the observation group at 2 h,12h and 24h after surgery were 2.16±0.45 points,2.76±0.64 points and 2.36±0.42 points,respectively,and which of the patients were significantly lower than those(3.56±1.10 points,4.75±1.26 points and 3.51±1.03 points)of the patients in the control group(all P<0.05).There was no significant difference in the total incidence of the adverse reactions(20.0%vs.26.7%)of the patients between the two groups(P>0.05).Conclusion:The application of DEX for the patients with laparoscopic myomectomy under total intravenous anesthesia can reduce their intraoperative dosage of propofol,stabilize their hemodynamics and relieve their postoperative pain,and without increase the medicine adverse reaction.
作者
陈鑫
孙思阳
沈雄
程明月
贺昌林
CHEN Xin;SUN Siyang;SHEN Xiong;CHENG Mingyue;HE Changlin(School of Medicine,Hangzhou Normal University,Hangzhou,Zhejiang Province,310000)
出处
《中国计划生育学杂志》
2025年第10期2235-2239,共5页
Chinese Journal of Family Planning
基金
杭州市生物医药和健康产业发展扶持科技专项(2023WJC056)。
