摘要
目的探讨右美托咪定联合丙泊酚在腹腔镜胆囊切除术患者麻醉中的镇痛和镇静效果。方法回顾性选取2019年6月至2020年11月本院收治的100例腹腔镜胆囊切除术患者,依据麻醉方法将其分为右美托咪定联合丙泊酚、瑞芬太尼组(右美托咪定组)和生理盐水联合丙泊酚、瑞芬太尼组(生理盐水组),各50例。比较两组患者的血流动力学指标、镇痛和镇静效果、术后自主呼吸恢复时间、清醒时间、拔管时间、不良反应发生情况。结果T_(0)、T_(1)、T_(2)、T_(3)、T_(4)时,右美托咪定组的心率、舒张压、收缩压均低于生理盐水组(P<0.05),且右美托咪定组的心率、舒张压、收缩压变化更为平稳。术后2、6、12 h,右美托咪定组的NRS静态、NRS动态评分均低于生理盐水组,Ramsay评分高于生理盐水组(P<0.05)。右美托咪定组的术后自主呼吸恢复时间、清醒时间、拔管时间均短于生理盐水组(P<0.05)。两组的不良反应总发生率无显著差异(P>0.05)。结论右美托咪定联合丙泊酚应用于腹腔镜胆囊切除术患者麻醉中的镇痛和镇静效果较生理盐水联合丙泊酚好,能够有效缩短患者的术后苏醒时间,且不增加不良反应,值得临床推广。
Objective To investigate the analgesic and sedative effects of dexmedetomidine combined with propofol in anesthesia of patients undergoing laparoscopic cholecystectomy.Methods A total of 100 patients underwent laparoscopic cholecystectomy admitted in our hospital from June 2019 to November 2020 were selected retrospectively.According to the anesthesia methods,the patients were divided into dexmedetomidine combined with propofol,remifentanil group(dexmedetomidine group)and normal saline combined with propofol,remifentanil group(normal saline group),with 50 cases in each group.The hemodynamics indexes,analgesic and sedative effects,postoperative recovery time of spontaneous breathing,wake time,extubation time and occurrence of adverse reactions of the two groups were compared.Results At T_(0),T_(1),T_(2),T_(3) and T_(4),the heart rate,diastolic blood pressure and systolic blood pressure in the dexmedetomidine group were lower than those in the normal saline group(P<0.05),and the changes of heart rate,diastolic blood pressure and systolic blood pressure in the dexmedetomidine group were more stable.At 2,6 and 12 h after operation,the NRS static and NRS dynamic scores in the dexmedetomidine group were lower than those in the normal saline group,and the Ramsay score was higher than that in the normal saline group(P<0.05).The postoperative recovery time of spontaneous breathing,waking time and extubation time in the dexmedetomidine group were shorter than those in the normal saline group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Dexmedetomidine combined with propofol has better analgesic and sedative effects than normal saline combined with propofol in anesthesia of patients undergoing laparoscopic cholecystectomy,and can effectively shorten the postoperative recovery time,without increasing adverse reactions,which is worthy of clinical promotion.
作者
管金萍
GUAN Jinping(Anesthesiology Department,the Second People's Hospital of Lianyungang,Lianyungang 222000,China)
出处
《临床医学研究与实践》
2022年第7期112-114,共3页
Clinical Research and Practice
