右美托咪定对宫颈锥切术麻醉的影响

目的:评价右美托咪定对宫颈锥切术麻醉效果的影响。方法:择期手术患者60例,随机分为2组(n=30):对照组(C组)和右美托咪定组(D组)。D组静脉输注右美托咪定1.0μg/kg(200μg加0.9%氯化钠溶液至50 mL,4μg/mL)。C组输注同等剂量0.9%氯化钠溶液。两组均给予芬太尼1μg/kg,丙泊酚1.5 mg/kg麻醉,待睫毛反射消失后行手术。记录患者入室时(T0)、右美托咪定输注5 min(T1)、手术开始时(T2)、手术结束时(T3)、自主睁眼时(T4)、自主睁眼后10 min(T5)HR、SBP、DBP、SpO2;手术时间;丙泊酚使用量;术后自主睁眼时间;自主睁眼后10 min Ramsay评分和手术部位疼痛情况;每组使用麻黄碱及阿托品的例数和总量;麻醉满意度评分。结果:D组丙泊酚用量、自主睁眼时间、伤口疼痛评分小于C组;阿托品使用例数和总量、Ramsay评分、麻醉满意度评价大于C组(P<0.05)。D组除在T1时HR、SBP低于C组(P<0.05)外,其余各时刻两组HR、SBP、DBP、SpO2差异均无统计学意义(P>0.05)。结论:右美托咪定用于LEEP时可减少丙泊酚用量、缩短术后苏醒时间、减轻患者创面疼痛程度,但应注意其对心率的影响。

Effects of Dexmedetomidine on Anesthesia in Loop Electrosurgical Excision Procedure

Objective To evaluate the effects of dexmedetomidine on anesthesia in loop electrosurgical excision procedure(LEEP).Methods Sixty patients were randomly divided into 2 groups(n=30): control group(group C) and dexmedetomidine group(group D).Dexmedetomidine were given with 1.0 μg/kg(200 μg add 0.9% normal saline(NS) to 50 mL,4 μg/mL)within 10 min in dexmedetomidine group and exmedetomidine was replaced by NS 50 mL in control group,then propofol was given with 1.5 mg/kg for anesthesia after fentanyl 1 μg/kg.The operation began after lash reflex disappeared.HR,SBP,DBP and SPO2 of basic(T0),5 min infusing dexmedetomidine(T1),operation beginning(T2),operation finished(T3),spontaneous open eyes(T4) and 10min after spontaneous open eyes(T5).Operation times,amount of propofol,time of spontaneous open eyes,ramsay score 10 min after spontaneous open eyes,times and amount of atropine and ephedrine were all recorded.The pain of operation and satisfaction with anesthesia were assessed.Results Amount and times of atropine,Ramsay score and satisfaction with anesthesia were higher,amount of propofol,time of spontaneous open eyes,pain of operation were lower.HR and SBP at T1 were lower in group D(P<0.05).Conclusion Dexmedetomidine can reduce amount of propofol and level of pain,shorten the recovery time in LEEP,but should observe the effect on HR.