临床误诊误治2024，Vol.37Issue(20)：81-86,6.DOI:10.3969/j.issn.1002-3429.2024.20.017
不同剂量右美托咪定对开腹全子宫切除术患者苏醒质量、血流动力学和应激反应的影响
Effects of Different Doses of Dexmedetomidine on Quality of Recovery,He-modynamics and Stress Response in Patients with Open Total Hysterectomy
摘要
Abstract
Objective To analyze the effects of different doses of Dexmedetomidine on the quality of recovery,hemo-dynamics and stress response in patients with open total hysterectomy.Methods A total of 93 patients who received open to-tal hysterectomy from January 2022 to January 2024 were divided into groups A,B and C by random number table method,with 31 patients in each group.Groups A and B received intravenous infusion of 0.50 μg/kg Dexmedetomidine at 10 min be-fore anesthesia induction,group C was received intravenous infusion of 0.5 mg/kg 0.9%Sodium Chloride.At 15 min before the end of surgery,groups A,B and C were injected with0.50,1.00 μg/kg Dexmedetomidine and0.5 mg/kg0.9%Sodium Chloride injection,respectively.The quality of recovery,Ramsay sedation score(RSS)and visual analogue scale(VAS)score at 1,6 and 12 h after surgery,hemodynamic indexes of all groups before induction of anesthesia(T1),at 1 min before extubation(T2),during extubation(T3)and at 3 min after extubation(T4),and stress response indexes of all groups at T1,T3 and T4 were compared.The adverse reactions in each group were followed up within 1 day.Results The time of re-covery and extubation in groups A and C was shorter than that in group B(P＜0.05).The RSS at 1,6 and12 h after surgery was gradually decreased(P＜0.05),and the RSS at 6 and 12 h after surgery in groups A and C was higher than that in group B(P＜0.05).The VAS score of the three groups at 1,6 and 12 h after surgery showed a trend of first increase and then de-crease(P＜0.05),and the VAS score of the three groups at12 h after surgery was higher than that at1 h after surgery(P＜0.05),and the VAS score of the three groups at6 and12 h after surgery was lower than that of group B(P＜0.05).Com-pared with T1 and T2,the diastolic blood pressure(DBP)and systolic blood pressure(SBP)of group C at T3 were increased(P＜0.05),and the DBP and SBP of group C at T4 were decreased compared with those at T3(P＜0.05).DBP and SBP in groups A and B were lower than those in group C at T2,T3 and T4(P＜0.05).Compared with T1 and T2,the heart rate of group C at T3 and T4 was increased(P＜0.05),and the heart rate of group A and B at T3 and T4 was lower than that of group C(P＜0.05).Compared with T1,plasma levels of adrenalin,adrenocorticotropic hormone(ACTH),cortisol and nor-epinephrine(NA)in groups A,B and C were gradually increased at T3 and T4(P＜0.05).At T3 and T4,the plasma levels of adrenalin,ACTH,cortisol and NA in group B were lower than those in groups A and C,and lower in group A than in group C(P＜0.05).The incidence of hypertension and tachycardia in groups A and B was lower than that in group C at1 d follow-up,and the incidence of hypotension and bradycardia in groups A and C was lower than that in group B(P＜0.05,P＜0.01).Conclusion Compared with 1.00 μg/kg Dexmedetomidine,0.50 μg/kg Dexmedetomidine can improve the quality of recovery in patients with open total hysterectomy,play a better sedative and analgesic effect,reduce the intraoperative stress response of patients,maintain a stable hemodynamic state,and has good safety.关键词
右美托咪定/开腹全子宫切除术/麻醉/苏醒质量/血流动力学/应激反应/药物毒性Key words
Dexmedetomidine/Open total hysterectomy/Anesthesia/Quality of recovery/Hemodynamics/Stress response/Drug toxicity分类
临床医学引用本文复制引用
贾小梅,高彦军..不同剂量右美托咪定对开腹全子宫切除术患者苏醒质量、血流动力学和应激反应的影响[J].临床误诊误治,2024,37(20):81-86,6.基金项目
国家卫生健康委"十四五"规划全国重点课题(YYWS5661) （YYWS5661）
陕西省2021年科技计划项目(2021SF-055) （2021SF-055）
