单次静注右美托咪定联合SLIPA喉罩 在妇科短小腔镜手术中的应用

目的 探讨右美托咪定联合SLIPA喉罩在妇科短小腔镜手术中的安全性和有效性。方法 择期全身麻醉下行腔镜卵巢囊肿剥除术的患者60例，随机分为A组和B组，每组30例。A组泵注右美托咪定0.4 μg/kg，于麻醉诱导前10 min内泵注完毕，B组患者同样时间泵注咪达唑仑0.06 mg/kg，其余麻醉诱导药物两组患者使用相同，当BIS≤45时，A组插入SLIPA喉罩，B组行气管插管。对比两组患者的手术时间、麻醉诱导开始到意识消失的时间、BIS降至45的时间、建立通气道的时间，T0~T5各时点两组患者的MAP、HR以及不良反应情况。结果 两组患者手术平均用时相比，差异无统计学意义（P＞0.05）。A组患者意识消失时间、BIS达到≤45的时间和建立通气道时间均短于B组，差异具有统计学意义（P＜0.05）。两组患者MAP和HR在T0、T3和T4时相比，差异无统计学意义（P＞0.05）。与T0比较，两组患者MAP和HR在T1时下降（P＜0.05）；与T1比较，B组的MAP和HR在T2时升高（P＜0.05）；A组在T2、T5时的MAP和HR低于B组（P＜0.05）。在麻醉诱导过程中，A组呛咳、窦性心动过缓和呼吸抑制的发生率低于B组（P＜0.05）；苏醒期A组咽痛、声嘶发生率低于B组（P＜0.05）。结论 单次静注右美托咪定联合SLIPA喉罩，可以有效维持围术期的血流动力学稳定，提高妇科患者在短小腔镜手术后的苏醒质量。

Application of Single Intravenous Dexmedetomidine Combined with SLIPA Laryngeal Mask in Gynecological Short Laparoscopic Surgery

Abstract:Objective To investigate the safety and efficacy of dexmedetomidine combined with SLIPA laryngeal mask in gynecologic short laparoscopic surgery.Methods 60 patients with laparoscopic ovarian cystectomy underwent elective general anesthesia were randomly divided into group A and group B,30 in each group.Group A was pumped with dexmedetomidine 0.4μg/kg,and the pump was completed within 10 minutes before induction of anesthesia.Group B patients were given midazolam 0.06 mg/kg at the same time. The remaining anesthetic-inducing drugs used the same two groups of patients.When BIS≤45,group A is inserted into the SLIPA laryngeal mask, and group B is intubated.The operation time of the two groups,the time from the start of anesthesia induction to the disappearance of consciousness,the time when BIS fell to 45,the time of establishing airway,and the MAP,HR and adverse reactions of the two groups at each time from T0 to T5.Results There was no significant difference in the average time between the two groups (P>0.05).The disappearance time of consciousness in patients in group A,the time when BIS reached≤45,and the time of establishing airway were shorter than those in group B,the difference was statistically significant(P<0.05).There was no significant difference in MAP and HR between the two groups at T0,T3 and T4(P>0.05).Compared with T0,MAP and HR decreased at T1(P<0.05).Compared with T1,MAP and HR of group B increased at T2(P<0.05);The MAP and HR of group A at T2 and T5 were lower than those of group B(P<0.05).During the induction of anesthesia,the incidence of cough,sinus bradycardia and respiratory depression in group A was lower than that in group B(P<0.05).The incidence of sore throat and hoarseness in group A was lower than that in group B(P<0.05). Conclusion A single intravenous injection of dexmedetomidine combined with SLIPA laryngeal mask can effectively maintain perioperative hemodynamic stability and improve the quality of gynecological patients after short laparoscopic surgery.