宫腔镜电切术应用右美托咪定联合七氟烷吸入麻醉的效果观察
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摘要
目的:探讨宫腔镜电切术应用右美托咪定联合七氟烷吸入麻醉的效果。方法:回顾性选取2016年12月至2017年12月湖北省京山县人民医院收治的拟行宫腔镜电切术治疗的妇科疾病患者108例作为研究对象,按麻醉方案不同分为观察组和对照组,每组54例。对照组患者行七氟烷吸入麻醉,观察组患者在对照组的基础上加用右美托咪定进行麻醉。于麻醉前(T_1)、术中(T_2)、术毕清醒时(T_3)、清醒后10 min(T_4)观察两组患者血压、心率及呼吸频率,比较两组患者的麻醉起效时间、麻醉苏醒时间、Ramsay评分、警觉/镇静观察评分、视觉模拟评分及不良反应发生情况的差异。结果:对照组患者T_2时的收缩压、舒张压及呼吸频率明显低于T_1时,观察组患者T_2、T_3及T_4时的心率明显低于对照组同期,观察组患者T_2时的呼吸频率明显低于对照组,上述差异均有统计学意义(P<0.05);两组患者麻醉起效时间、麻醉苏醒时间的差异均无统计学意义(P>0.05);术后,观察组患者Ramsay评分、警觉/镇静观察评分及视觉模拟评分明显优于对照组,差异均有统计学意义(P<0.05);观察组患者术后不良反应发生率为11.11%(6/54),明显低于对照组的29.63%(16/54),差异有统计学意义(P<0.05)。结论:宫腔镜电切术应用右美托咪定联合七氟烷吸入麻醉的效果显著,能减少患者术中血流动力学波动,镇静、镇痛效果良好,麻醉不良反应少。
OBJECTIVE: To probe into the anesthesia effects of dexmedetomidine combined with sevoflurane inhalation in hysteroscopic resection. MET_HODS: 108 patients with gynecologic diseases accepting hysteroscopic resection admitted into Hubei Jingshan County People's Hospital from Dec. 2016 to Dec. 2017 were retrospectively selected and divided into observation group and control group via different anesthesia regimen,with 54 cases in each.The control group was given sevoflurane inhalation anesthesia,while the observation group additionally received dexmedetomidine based on the control group. The blood pressure,heart rate and respiratory rate of two groups in preanesthesia( T_1),intra-operative( T_2),awaking after operation( T_3) and 10 min after awaking( T_4) were observed;and the onset time of anesthesia,recovery time,Ramsay score,alert/sedation score,visual analogue scale( VAS) and incidence of adverse drug reactions of two groups were compared. RESULTS: The systolic blood pressure,diastolic blood pressure and respiratory rate of control group in T_2 was significantly lower than that in T_1. The heart rate of observation group in T_2,T_3 and T_4 was significantly lower than that of the control group; the respiratory rate of observation group in T_2 was significantly lower than that of control group,with statistically significant differences( P <0. 05). There was no statistically significance between two groups in the onset time of anesthesia and recovery time( P > 0. 05). After operation,the Ramsay score,alert/sedation score,VAS of observation group were significantly better than those of control group,with statistically significant difference( P < 0. 05). The incidence of adverse drug reactions of observation group was 11. 11%( 6/54),significantly lower than that of control group( 29. 63%,16/54),with statistically significant difference( P < 0. 05). CONCLUSIONS: The anesthesia effects of dexmedetomidine combined with sevoflurane inhalation in hysteroscopic resection is significant, which can reduce fluctuations in hemodynamics in patients,with better sedative and analgesic effect and fewer adverse drug reactions.
OBJECTIVE: To probe into the anesthesia effects of dexmedetomidine combined with sevoflurane inhalation in hysteroscopic resection. MET_HODS: 108 patients with gynecologic diseases accepting hysteroscopic resection admitted into Hubei Jingshan County People's Hospital from Dec. 2016 to Dec. 2017 were retrospectively selected and divided into observation group and control group via different anesthesia regimen,with 54 cases in each.The control group was given sevoflurane inhalation anesthesia,while the observation group additionally received dexmedetomidine based on the control group. The blood pressure,heart rate and respiratory rate of two groups in preanesthesia( T_1),intra-operative( T_2),awaking after operation( T_3) and 10 min after awaking( T_4) were observed;and the onset time of anesthesia,recovery time,Ramsay score,alert/sedation score,visual analogue scale( VAS) and incidence of adverse drug reactions of two groups were compared. RESULTS: The systolic blood pressure,diastolic blood pressure and respiratory rate of control group in T_2 was significantly lower than that in T_1. The heart rate of observation group in T_2,T_3 and T_4 was significantly lower than that of the control group; the respiratory rate of observation group in T_2 was significantly lower than that of control group,with statistically significant differences( P <0. 05). There was no statistically significance between two groups in the onset time of anesthesia and recovery time( P > 0. 05). After operation,the Ramsay score,alert/sedation score,VAS of observation group were significantly better than those of control group,with statistically significant difference( P < 0. 05). The incidence of adverse drug reactions of observation group was 11. 11%( 6/54),significantly lower than that of control group( 29. 63%,16/54),with statistically significant difference( P < 0. 05). CONCLUSIONS: The anesthesia effects of dexmedetomidine combined with sevoflurane inhalation in hysteroscopic resection is significant, which can reduce fluctuations in hemodynamics in patients,with better sedative and analgesic effect and fewer adverse drug reactions.
引文
[1]王阿琳,王正坤,付晖.七氟烷与地佐辛复合吸入麻醉用于宫腔镜电切术的效果分析[J].中国医药科学,2015,5(4):101-102,110.
[2]许哲,颜成玉.右美托咪啶静脉泵注联合七氟烷吸入诱导在宫腔镜手术麻醉中的应用效果[J].当代医学,2017,23(12):136-137.
[3]余念恩,李平,李安学.七氟烷和右美托咪定联合诱导对下腹部手术患者血气指标及诱导期的影响[J].中国当代医药,2015,22(21):47-49,53.
[4]邱秋英,侯芝琦,宋泽林.右美托咪定静脉泵注结合七氟烷吸入诱导在宫腔镜手术麻醉中的应用[J].白求恩医学杂志,2016,14(1):36-38.
[5]王利祥,杨明乾,刘会长.氢吗啡酮预防全麻腹腔镜手术苏醒期躁动的效果[J].实用临床医药杂志,2014,18(21):144-145.
[6]胡志超,孔莉,许鹏程,等.不同剂量右美托咪定镇静程度及顺行性遗忘作用研究[J].国际麻醉学与复苏杂志,2015,36(7):582-586.
[7]徐一刚,孙正英,孙杰,等.帕瑞昔布钠在经产妇剖宫产术后减轻子宫收缩痛的观察[J].临床麻醉学杂志,2015,31(9):885-887.
[8]李玉梅,安玉娟,周刚,等.地佐辛复合七氟烷吸入麻醉在宫腔镜电切术中的应用[J].中国实用医刊,2014,41(4):41-43.
[9]徐明坤,颜振艺,曹殿青.右美托咪定静脉泵泵注联合七氟烷吸入诱导在宫腔镜手术麻醉中的应用[J].实用临床医学,2017,18(2):54-55,57.
[10]应震阳,朱彬,张云珍.七氟烷或异丙酚复合瑞芬太尼麻醉在老年人宫腔镜手术中的应用比较[J].中华危重症医学杂志:电子版,2017,10(1):48-50.
[11]陈新艳,牛世坤,房先杰,等.右美托咪定联合七氟烷吸入在宫腔镜电切术中的麻醉效果研究[J].中国内镜杂志,2017,23(6):21-25.
[12]周文,阳兴,余云明,等.右美托咪定静脉泵注联合七氟烷吸入诱导在宫腔镜手术麻醉中的应用[J].中外医学研究,2017,15(13):27-28.
[13]徐洪刚,吴媛媛,王昊.右美托咪定对胃肠道开腹手术瑞芬太尼诱发痛觉过敏的影响[J].医学与哲学,2014,35(22):52-54.
[14]谭素云,肖圣华,王智钧,等.不同剂量右美托咪定联合超低剂量纳洛酮对瑞芬太尼诱发的术后痛觉过敏的影响[J].实用医学杂志,2015,31(15):2486-2489.
[2]许哲,颜成玉.右美托咪啶静脉泵注联合七氟烷吸入诱导在宫腔镜手术麻醉中的应用效果[J].当代医学,2017,23(12):136-137.
[3]余念恩,李平,李安学.七氟烷和右美托咪定联合诱导对下腹部手术患者血气指标及诱导期的影响[J].中国当代医药,2015,22(21):47-49,53.
[4]邱秋英,侯芝琦,宋泽林.右美托咪定静脉泵注结合七氟烷吸入诱导在宫腔镜手术麻醉中的应用[J].白求恩医学杂志,2016,14(1):36-38.
[5]王利祥,杨明乾,刘会长.氢吗啡酮预防全麻腹腔镜手术苏醒期躁动的效果[J].实用临床医药杂志,2014,18(21):144-145.
[6]胡志超,孔莉,许鹏程,等.不同剂量右美托咪定镇静程度及顺行性遗忘作用研究[J].国际麻醉学与复苏杂志,2015,36(7):582-586.
[7]徐一刚,孙正英,孙杰,等.帕瑞昔布钠在经产妇剖宫产术后减轻子宫收缩痛的观察[J].临床麻醉学杂志,2015,31(9):885-887.
[8]李玉梅,安玉娟,周刚,等.地佐辛复合七氟烷吸入麻醉在宫腔镜电切术中的应用[J].中国实用医刊,2014,41(4):41-43.
[9]徐明坤,颜振艺,曹殿青.右美托咪定静脉泵泵注联合七氟烷吸入诱导在宫腔镜手术麻醉中的应用[J].实用临床医学,2017,18(2):54-55,57.
[10]应震阳,朱彬,张云珍.七氟烷或异丙酚复合瑞芬太尼麻醉在老年人宫腔镜手术中的应用比较[J].中华危重症医学杂志:电子版,2017,10(1):48-50.
[11]陈新艳,牛世坤,房先杰,等.右美托咪定联合七氟烷吸入在宫腔镜电切术中的麻醉效果研究[J].中国内镜杂志,2017,23(6):21-25.
[12]周文,阳兴,余云明,等.右美托咪定静脉泵注联合七氟烷吸入诱导在宫腔镜手术麻醉中的应用[J].中外医学研究,2017,15(13):27-28.
[13]徐洪刚,吴媛媛,王昊.右美托咪定对胃肠道开腹手术瑞芬太尼诱发痛觉过敏的影响[J].医学与哲学,2014,35(22):52-54.
[14]谭素云,肖圣华,王智钧,等.不同剂量右美托咪定联合超低剂量纳洛酮对瑞芬太尼诱发的术后痛觉过敏的影响[J].实用医学杂志,2015,31(15):2486-2489.