盐酸右美托咪定用于全麻腹腔镜下卵巢囊肿切除术的临床观察

目的探讨腹腔镜下卵巢囊肿切除术中应用盐酸右美托咪定的安全性和有效性。方法 40例择期行腹腔镜下卵巢囊肿切除术的患者,随机分为盐酸右美托咪定组(D组)和对照组(C组),每组20例。D组麻醉诱导前10 min给予盐酸右美托咪定0.5μg/kg,10 min静脉泵入;C组给予等容量生理盐水10 min静脉泵入。取患者入室(T0)、输注完盐酸右美托咪定或等容量生理盐水即刻(T1)、气腹后5 min(T2)、拔除喉罩即刻(T3)各时点,记录心率(HR)、平均动脉压(MAP),测定T0、T2时点血糖值,并记录患者的手术时间和喉罩拔除时间(从手术结束到拔除喉罩)。结果 D组患者与C组对比,心率(HR)在T1、T2、T3时点差异均存在统计学意义(P<0.05),而T0时点差异无统计学意义(P>0.05),D组较C组心率下降明显。D组患者与C组比较,平均动脉压(MAP)在T2和T3时点差异有统计学意义(P<0.05),术中D组患者血压较C组明显平稳。血糖值T2时点C组与D组差异有统计学意义(P<0.05)。D组患者的术后拔除喉罩时间少于C组。结论在腹腔镜下卵巢囊肿剔除术中应用盐酸右美托咪定,可以有效地维持患者血流动力学稳定,降低应激反应,缩短拔除喉罩时间。

Clinical observation of dexmedetomidine in laparoscopic oophorocystectomy

Objective To investigate the safety and efficacy of dexmedetomidine in laparoscopic oophorocystectomy.Methods Forty patients scheduled for selective laparoscopic oophorocystectomy were randomly assigned to two groups:group D(Intravenous dexmedetomidine 0.5 μg/kg),group C(The same volume of normal saline),20 patients in each group.Group D and group C respectively received dexmedetomidine and normal saline 10 mins before the induction of anesthesia by intravenous infusion(the duration time of infusion was 10 mins).Patients′ heart rate(HR),mean arterial pressure(MAP)were recorded,and the blood glucose levels were measured at the time of entering the operating room(T0),the end of infusing dexmedetomidine and normal saline(T1),5 mins after pneumoperitoneum(T2)and extubating laryngeal mask(T3).The extubation time was also recorded.Results There were significant differences between group D and group C HR at T1,T2 and T3(P<0.05).Compared with group C,HR of group D decreased significantly.There was significant difference between group D and group C in MAP at T2 and T3(P<0.05).BP of group D was more stable than group C.There was significant difference between group D and group C in blood glucose levels at T2(P<0.05).There was difference between group D and group C in extubation time(P<0.05).Conclusion During laparoscopic oophorocystectomy,dexmedetomidine can stabilize hemodynamics,inhibit stress reaction and shorten extubation time.