摘要
目的:探讨右美托咪定对绝经前腹腔镜子宫肌瘤切除术患者麻醉诱导期镇痛及应激反应的影响。方法:选取80例绝经前腹腔镜子宫肌瘤切除术患者作为研究对象,以随机数字表法分为观察组与对照组各40例,麻醉诱导期对照组采用0.9%氯化钠溶液联合舒芬太尼,观察组给予右美托咪定联合舒芬太尼。对比两组麻醉方案的效果差异。结果:①观察组临床相关指标优于对照组(P<0.05);②观察组术后1、6、12、24、48 h视觉模拟法(VAS)评分低于对照组(均P<0.05);③气管插管5 min、麻醉30 min、手术结束时观察组心率(HR)、平均动脉压(MAP)水平低于对照组(均P<0.05);④麻醉30 min、术后1 d观察组超氧化物歧化酶(SOD)水平高于对照组,丙二醛(MDA)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平低于对照组(均P<0.05);④观察组麻醉苏醒期躁动发生率低于对照组(均P<0.05),麻醉30 min、苏醒后观察组褪黑素含量高于对照组(P<0.05);⑤术后1 d两组睡眠质量评分均明显上升,观察组低于对照组(均P<0.05)。结论:右美托咪定能够增强绝经前腹腔镜子宫肌瘤切除术患者麻醉诱导期镇痛效果,降低应激反应及保持生命体征平稳,控制麻醉苏醒期躁动风险,改善睡眠质量,缩短术后康复进程。
Objective:To investigate the effect of dexmedetomidine on analgesia and stress response during induction of anesthesia in premenopausal patients undergoing laparoscopic myomectomy.Methods:80 premenopausal patients undergoing laparoscopic myomectomy were selected as the research objects,and they were divided into observation group and control group with 40 cases each by random number table method.During the induction of anesthesia,the control group was treated with 0.9%sodium chloride solution combined with sufentanil,the observation group was treated with dexmedetomidine combined with sufentanil.The effects of the two groups of anesthesia programs was compared.Results:The clinical indicators of the observation group were better than those of the control group(all P<0.05).The VAS scores of the observation group at 1,6,12,24 and 48 hours after operation were lower than those of the control group(all P<0.05).The heart rate(HR)and mean arterial pressure(MAP)of the observation group were lower than those of the control group at the end of tracheal intubation for 5 minutes and anesthesia for 30 minutes(all P<0.05).After 30 min of anesthesia and 1 day after surgery,the level of oxide dismutase(SOD)was higher than that of the control group,and the levels of malondialdehyde(MDA),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)were lower than those of the control group(all P<0.05).The incidence of agitation in the observation group during recovery from anesthesia was lower than that in the control group(P<0.05),and the melatonin contents in the observation group were higher than those in the control group after 30 minutes of anesthesia and recovery from anesthesia(all P<0.05).One day after surgery,the sleep quality scores in both groups were significantly increased,and the observation group was lower than the control group(all P<0.05).Conclusion:Dexmedetomidine can enhance the analgesic effect of premenopausal patients undergoing laparoscopic myomectomy during anesthesia induction period,reduce stress response and maintain the stability of vital signs,control the risk of agitation during anesthesia recovery period,improve sleep quality,and shorten the process of postoperative rehabilitation.
作者
曾克非
夏婷婷
ZENG Kefei;XIA Tingting(Affiliated Hospital of Jinggangshan University,Ji’an 343000,China)
出处
《陕西医学杂志》
CAS
2021年第11期1433-1436,1445,共5页
Shaanxi Medical Journal
关键词
右美托咪定
绝经前期
腹腔镜
肌瘤切除术
麻醉诱导期
镇痛
Dexmedetomidine
Premenopausal
Laparoscope
Myomectomy
Anesthesia induction period
Analgesia
