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[目的]观察小剂量右美托咪定对腹腔镜妇科手术中的血流动力学和镇静镇痛药物用量的影响。[方法]选择全麻下行腹腔镜妇科手术的患者60例,美国麻醉医师协会(ASA)分级为Ⅰ～Ⅱ级,随机分为右美托咪定组(D组)和对照组(C组),每组各30例。记录诱导前(T0)、诱导后(T1)、插管后即刻(T2)、插管后10min(T3)、插管后30min(T4)和插管后50min(T5)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率(HR)。记录两组维持相同麻醉深度的丙泊酚、舒芬太尼和顺式阿曲库铵用量及不良反应发生情况。[结果]D组T3和T4的SBP、DBP、MAP均低于C组(P<0.05)。D组T3和T4的HR低于C组(P<0.01)。D组患者丙泊酚和舒芬太尼用量明显少于C组(P<0.01)。D组不良反应的发生率与C组无明显差别。[结论]小剂量右美托咪定能稳定腹腔镜妇科手术术中的血流动力学,减少镇静镇痛药物用量,不良反应少。
[Objective] To observe the effects of low-dose dexmedetomidine on hemodynamics and sedative analgesic in laparoscopic gynecological surgery. [Methods] Sixty patients undergoing laparoscopic gynecological surgery under general anesthesia were randomly divided into two groups. The American Society of Anesthesiologists (ASA) was graded as grade Ⅰ ~ Ⅱ and were randomly divided into dexmedetomidine group (D group) and control group (C group) , Each group of 30 cases. Systolic blood pressure (SBP) was recorded before induction (T0), after induction (T1), immediately after intubation (T2), 10 min after intubation (T3), 30 min after intubation (T4) and 50 min after intubation (T5) , Diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR). The dosage of propofol, sufentanil and cisatracurium and the incidence of adverse reactions were recorded in two groups to maintain the same anesthesia depth. [Results] The SBP, DBP and MAP of group D and T3 were lower than those of group C (P <0.05). The HR of T3 and T4 in group D was lower than that in group C (P <0.01). The dosage of propofol and sufentanil in group D was significantly less than that in group C (P <0.01). The incidence of adverse reactions in group D was not significantly different from that in group C [Conclusion] A small dose of dexmedetomidine can stabilize the hemodynamics during laparoscopic gynecological surgery, reduce the dosage of sedative and analgesic drugs, and have fewer adverse reactions.