摘要
目的探讨右美托咪定(Dex)对妇科腹腔镜手术患者七氟醚最低肺泡浓度(MACBAR)及苏醒期质量的影响。方法选取80例接受妇科腹腔镜手术患者,随机均分为Dex组和对照组,采用七氟醚吸入维持麻醉的方式,Dex组于全麻诱导前静脉输注Dex0.5μg/kg(10 min内输完)、术中维持Dex用法,对照组给予等量生理盐水;两组患者术中脑电双频指数(BIS)维持45~55,记录两组患者在输注Dex前(T0)、输注Dex10 min后(T1)、气腹后即刻(T2)、气腹30 min(T3)及气腹结束(T4)时间点的吸入七氟醚浓度值、心率(HR)和平均动脉压(MAP);记录两组患者苏醒时间、七氟醚MACBAR值、苏醒期Ricker镇静躁动评分及相关不良反应(头晕、嗜睡、躁动、尿潴留等)的发生率。结果T0、T1时刻,两组患者MAP、HR差异无统计学意义(P>0.05);T2~T4时刻,Dex组患者的MAP、HR监测值均低于对照组(P<0.05);T0时刻,两比较组患者七氟醚吸入浓度差异无统计学意义(P>0.05);T1~T4时刻,Dex组患者的七氟醚吸入浓度低于对照组,差异有统计学意义(P<0.05);Dex组和对照组的七氟醚MACBAR值、苏醒5 min后的Ricker镇静评分均低于对照组,差异有统计学意义(P<0.05)。Dex组和对照组的苏醒时间、气腹结束时的Ricker镇静评分、麻醉相关不良反应对比(5.00%vs 17.50%)比较,差异无统计学意义(P>0.05)。结论妇科腹腔镜手术患者七氟醚吸入维持麻醉前采用Dex进行麻醉诱导对患者血流动力学稳定、降低MACBAR值、提高患者苏醒期质量有积极作用。
Objective To explore the effect of dexmedetomidine(Dex)on the minimum alveolar concentration of sevoflurane needed to block autonomic response(MACBAR)and the quality of awaken period in patients undergoing gynecological laparoscopic surgery.Methods Eighty patients undergoing gynecological laparoscopic surgery were randomly divided into Dex group and control group.Sevoflurane inhalation was used to maintain anesthesia.The Dex group received intravenous infusion of Dex 0.5μg/kg(within 10 minutes)before induction of general anesthesia and Dex usage was maintained during the operation.Control group was given the same amount of normal saline.EEG bispectral index(BIS)of the two groups was maintained at 45-55 during operation.Inhaled sevoflurane concentration,heart rate(HR)and mean arterial pressure(MAP)of patients in two groups were recorded at the following time points:before Dex infusion(T0),10 minutes after Dex infusion(T1),immediately after pneumoperitoneum(T2),and pneumoperitoneum at 30 min(T3)and end of pneumoperitoneum(T4).Awaken time,MACBAR of sevoflurane,Ricker sedation agitation score(SAS)and the incidence of adverse reactions(dizziness,drowsiness,restlessness,urinary retention,etc.)were recorded.Results At T0 and T1,there was no significant difference in MAP and HR between two groups(P>0.05).At T2 to T4,MAP and HR in Dex group were lower than those of control group(P<0.05).At T0,there was no significant difference in inhaled sevoflurane concentration between two groups(P>0.05).At T1-T4,the inhaled sevoflurane concentration in the Dex group was lower than that in control group(P<0.05).There were no significant differences in awaken time,Ricker sedation score at the end of the pneumoperitoneum and anesthesia-related adverse reactions(5.00%vs 17.50%)between two groups(P>0.05).Conclusion Before inhalation of sevoflurane to maintain anesthesia,Dex-mediated anesthesia induction in patients undergoing gynecological laparoscopic surgery stabilize hemodynamics,reduce MACBAR,and improve the quality of awaken period.
作者
陈俊
王绍林
CHEN Jun;WANG Shaolin(Department of Anesthesiology,the Second People’s Hospital of Wuhu,Wuhu 241000,Anhui,China)
出处
《贵州医科大学学报》
CAS
2021年第4期482-486,共5页
Journal of Guizhou Medical University
基金
芜湖市科技计划重点项目(2013HM24)。
关键词
妇科学
右美托咪定
腹腔镜手术
七氟醚
最低肺泡浓度
gynecology
dexmedetomidine(Dex)
laparoscopic surgery
sevoflurane
minimum alveolar concentration
