右美托咪定、七氟烷联合全麻下喉罩通气行宫腔镜手术的疗效观察

目的 分析右美托咪定结合七氟烷喉罩全麻对宫腔镜手术患者血流动力学指标和麻醉情况的影响.方法 选取2014年3月至2015年3月80例在济南军区总医院行宫腔镜手术患者80例,分为观察组和实验组,两组各40例,观察组经生理盐水静脉泵注并结合七氟烷全麻,实验组经右美托咪定结合七氟烷喉罩全麻,并对比分析两组血流动力学指标和麻醉起效时间等情况.结果 观察组与实验组泵注后3 min、喉罩置入后3 min时平均动脉压、心率均较麻醉前显著降低(t值分别为-3.85、-4.24、-4.36、-4.15,均P<0.05),且实验组的平均动脉压及心率均较观察组降低更为明显(t值分别为-2.21、-3.98、-6.87、-5.63,均P<0.05).实验组麻醉诱导时间、苏醒时间均较观察组显著缩短(t值分别为-3.78、-4.14,均P<0.05),且其Ramesay镇静程度、OAA/S清醒程度评分均较观察组高(t值分别为4.25、6.96,均P<0.05);实验组恶心、呕吐、呼吸抑制等并发症发生率较观察组低(χ2值分别为13.04、16.98、12.75,均P<0.05).结论 右美托咪定结合七氟烷喉罩全麻能够改善宫腔镜手术患者的血流动力学指标,且能够缩短麻醉诱导时间及苏醒时间,有效减少术后并发症,安全性、可靠性较高,临床上值得推广和应用.

Observation on effects of dexmedetomidine combining sevoflurane for general anesthesia with laryngeal mask ventilation in hysteroscopic surgery

Objective To analyze the effects of dexmedetomidine combining sevoflurane for laryngeal mask anesthesia on hemodynamics indexes and anesthesia in hysteroscopic surgery.Methods Totally 80 cases receiving hysteroscopic surgery were selected from General Hospital of Jinan Military Area.They were divided into observation group undergoing normal saline intravenous infusion combining sevoflurane for general anesthesia and experiment group receiving dexmedetomidine with sevoflurane for laryngeal mask anesthesia, with 40 cases in each.The hemodynamics indexes and anesthesia onset time were compared between two groups.Results The mean arterial pressure (MAP) and heart rate (HR) of two groups 3 minutes after infusion and laryngeal mask anesthesia for 3 minutes were lower than those before anesthesia (t value was-3.85,-4.24,-4.36 and-4.15, respectively, all P<0.05), and MAP and HR in the experiment group declined more significantly than the observation group (t value was-2.21,-3.98,-6.87 and-5.63, respectively, all P<0.05).The induction time and awake time in the experiment group were shorter than those in the observation group (t value was-3.78 and-4.14, respectively, both P<0.05), and the scores of Ramesay and observer''s assessment of alertness/sedation (OAA/S) were higher than in the observation group (t value was 4.25 and 6.96, respectively, both P<0.05).The incidence rate of nausea, vomiting and respiratory depression in the experiment group were lower than in the observation group (χ2 value was 13.04, 16.98 and 12.75, respectively, all P<0.05).Conclusion Dexmedetomidine combining sevoflurane for laryngeal mask anesthesia can improve the hemodynamics indexes of patients undergoing hysteroscopic surgery, shorten anesthesia induction and awake time, and reduce postoperative complications with high safety and reliability, so it is worthy of clinical promotion and application.