右美托咪定和丙泊酚用于硬膜外麻醉下妇科手术患者的镇静效果比较研究

目的 比较右美托咪定和丙泊酚用于硬膜外麻醉下妇科手术的镇静效果.方法 选取2010年7月～2013年7月本院妇科病房收治的手术患者110例,两组受试者均采用硬膜外麻醉给药,监测记录患者用药前（T0）、用药后15 min（T1）,进行手术后15 min （T2）、30 min（T3）、45 min （T4）,手术结束时（T5）、30 min （T6）的脑电双频谱指数（BIS）、心率（HR）、血液流变学（HR）、平均动脉压（MVP）等基础生命指征及采用听觉诱发电位指数（AEP index）、Ramsay镇静评分,用来评价麻醉效果.结果 A组和B组患者在使用硬膜外麻醉后,HR、Bp较麻醉前有所下降（P＜0.05）,且B组较A组下降更明显,两组比较差异显著（P＜0.05）.两组患者麻醉前后的AEP index、BIS下降,Ramsay镇静评分增高,A组较B组改变明显（P＜0.05）.结论 右美托咪定与丙泊酚用于硬膜外麻醉下妇科手术时,均能达到较好的麻醉效果,但右美托咪定对于患者生命体征影响较小,不良反应少,麻醉效果也更为出色.

Comparative study on sedative effect of dexmedetomidine and propofol used for epidural anesthesia in gynecological surgery of patients

Objective To compare the effects of dexmedetomidine and propofol used for epidural anesthesia in gyneco- logicoperation sedative effect. Methods A total of 110 patients in gynecology ward of our hospital from July 2010 to July 2013 were randomly divided. Two groups were given medicine by epidural anesthesia,basic vital signs of patients such as bispectral index（BIS）,heart rate （HR）,hemorheology,mean arterial pressure and so on of two groups before med- ication （T0）,15 minutes after medication （T1）,15 minutes of surgery （T2）,30 minutes （T3）,45 minutes of surgery（T4）,when surgery completed （TS） and 30 minutes after surgery（T6） were detected,evaluated the sedative effect by auditory evoked potential index （AEP index） and Ramsay sedation score. Results A group and B group of patients using epidural anes- thesia in the post, HR, Bp than before anesthesia （P〈O.05）, and decreased in B group than in A group decreased more- significantly, the difference between the two groups was significant （P〈0.05）.Patients in the two groups before and after anesthesia, AEP index, BIS decreased, Ramsay sedation score increased, A group than in B groupsignificantly（P〈0.05）. Conclusion Dexmedetomidine and propofol epidural anesthesia in gynecologic operation, can achieve the good effects of anesthesia, but the right of dexmedetomidine on vital signs of patients with less effect, less adverse reaction, anesthesia effect is more outstanding.