临床外科杂志 ›› 2020, Vol. 28 ›› Issue (7): 690-692.doi: 10.3969/j.issn.1005-6483.2020.07.028

• • 上一篇    下一篇

右美托咪定在侧卧位静脉麻醉下混合痔切除术中的应用

  

  1. 638000 四川省广安市人民医院(四川大学华西广安医院)麻醉科
  • 出版日期:2020-07-20 发布日期:2020-07-20
  • 通讯作者: 张春梅,Email:zjc5@163.com

Application of dexmedetomidine in mixed hemorrhoidectomy under intravenous anesthesia in lateral decubitus position

  1. Department of Anesthesiology,Guang'an People's Hospital(West China Guang'an Hospital,Sichuan University),Guang'an,Sichuan 638000,China
  • Online:2020-07-20 Published:2020-07-20

摘要: 目的 分析右美托咪定在侧卧位静脉麻醉下混合痔切除术的应用效果。
方法 混合痔切除术病人60例,采用随机数字表法分为对照组和研究组,每组各30例。两组均予以异丙酚麻醉诱导,对照组予以瑞芬太尼加异丙酚麻醉维持,研究组予以瑞芬太尼加右美托咪定麻醉维持。比较两组瑞芬太尼、异丙酚用量,麻醉苏醒质量,不同时间点心率(HR)、平均动脉压(MAP)和脑电双频指数(BIS),视觉模拟评分(VAS)和不良反应发生情况。
结果 研究组异丙酚、瑞芬太尼用量少于对照组,差异有统计学意义(P<0.05)。两组呼吸恢复时间、清醒时间比较差异无统计学意义(P>0.05)。麻醉诱导前,两组HR、MAP和BIS比较差异无统计学意义(P>0.05);手术开始后10分钟时,两组HR、MAP均上升,研究组低于对照组,手术开始后10分钟BIS均下降,且研究组低于对照组,差异有统计学意义(P<0.05)。术后1小时、4小时,研究组VAS评分低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。
结论 混合痔切除术在静脉麻醉基础上给予右美托咪定未延迟病人苏醒时间,减少麻醉药物剂量,可保持血流动力学平稳并减轻疼痛,安全性高。

关键词: 右美托咪定, 侧卧位, 静脉麻醉, 混合痔切除术

Abstract: Objective To analyze the application effect of dexmedetomidine in mixed hemorrhoidectomy under intravenous anesthesia in lateral position.
 Methods 60 patients undergoing mixed hemorrhoidectomy were divided into control group and research group according to random number table method,with 30 cases in each group,and were divided into control group and research group according to random number table method,with 30 cases in each group.Both groups were induced by propofol anesthesia,the control group was maintained by remifentanil and propofol anesthesia,and the study group was maintained by remifentanil and dexmedetomidine anesthesia.The dosage of remifentanil and propofol,anesthesia recovery quality,heart rate(HR),mean arterial pressure(MAP),bispectral index(BIS),visual analogue scale(VAS),and adverse reactions were compared between the two groups.
ResultsThe dosage of propofol and remifentanil in the research group was lesser than that in the control group(P<0.05).There was no significant difference in respiratory recovery time and awake time between the two groups(P>0.05).Before anesthesia induction,there was no significant difference in HR,MAP and BIS between the two groups(P>0.05).HR and MAP in both groups increased 10min after the operation,while BIS in the research group was lower than that in the control group and decreased 10min after the operation,and the research group was lower than that in the control group(P<0.05).The VAS score of the research group was lower than that of the control group 1 hour and 4 hours after operation(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).
Conclusion Dexmedetomidine on the basis of intravenous anesthesia for mixed hemorrhoid resection does not delay the recovery time of patients and reduces the dosage of narcotic drugs,which can maintain stable hemodynamics and relieve pain,and has high safety.

Key words: dexmedetomidine, lateral position, intravenous anesthesia, excision of mixed hemorrhoids

[1] 吕晶, 胡艺川, 姚尚龙. 右美托咪定不同给药途径复合头皮神经阻滞对围术期血流动力学和应激反应的影响[J]. 临床外科杂志, 2019, 27(12): 1074-1076.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 王延磊, 戴勇. 腹腔镜直肠癌全直肠系膜切除术质控要点[J]. 临床外科杂志, 2020, 28(5): 404 -406 .
[2] 邓祥兵, 张豪, 王自强. 盆内筋膜与盆内脏血管神经关系的研究进展及侧方淋巴结清扫术的技术改良[J]. 临床外科杂志, 2020, 28(5): 407 -411 .
[3] 韩方海, 钟广宇. 直肠癌全直肠系膜切除手术中保护盆腔自主神经的技术路径[J]. 临床外科杂志, 2020, 28(5): 412 -415 .
[4] 梁太平, 裴轶飞, 周建等. 主动脉夹层的治疗现状与未来[J]. 临床外科杂志, 2020, 28(6): 501 -503 .
[5] 李永康, 王南鹏, 杨能红. 左颈清术后合并双侧乳糜胸及肺炎一例[J]. 临床外科杂志, 2020, 28(6): 598 .
[6] 袁野 金润森 李鹤成. 机器人手术在肺癌外科的现状和展望[J]. 临床外科杂志, 2020, 28(7): 601 -604 .
[7] 李宗元 陈晓烨 刘伦旭. 机器学习在肺癌外科的研究进展[J]. 临床外科杂志, 2020, 28(7): 605 -607 .
[8] 滕啸 胡坚. 非小细胞肺癌新辅助免疫治疗前景[J]. 临床外科杂志, 2020, 28(7): 608 -610 .
[9] 张帆 谭锋维 薛奇 高树庚. 免疫检查点抑制剂在非小细胞肺癌新辅助治疗中的现状[J]. 临床外科杂志, 2020, 28(7): 611 -614 .
[10] 傅睿 钟文昭. 外科在Ⅲ期非小细胞肺癌多学科综合治疗中的地位[J]. 临床外科杂志, 2020, 28(7): 615 -617 .