右美托咪定对腹腔镜子宫肌瘤剔除术患者镇痛效果及认知功能的影响

Impact of dexmedetomidine on the analgesia effect and cognitive function in patients with laparoscopic myomectomy

摘要:

目的 探讨右美托咪定对腹腔镜子宫肌瘤剔除术（LM）患者镇痛效果及认知功能的影响。方法 选取2018年11月－2020年11月该院LM患者128例，依据随机数表法分为定全组（n = 64）和单全组（n = 64），单全组给予全身麻醉处理，定全组在此基础上给予右美托咪定处理，比较两组患者血流动力学［平均动脉压（MAP）和心率（HR）］、镇痛效果［视觉模拟评分法（VAS）］、全身麻醉药用量、认知功能［简易精神状态检查量表（MMSE）］和不良反应发生率。结果 定全组麻醉30 min时（T₁）、肌瘤剔除时（T₂）和术毕时（T₃）的MAP、HR及术后2、6和12 h的VAS均明显低于单全组（P < 0.05）；定全组全身麻醉用药量少于单全祖，认知功能障碍率低于单全组，定全组术后12、24和48 h的MMSE评分明显高于单全组（P < 0.05）；定全组不良反应率低于单全组，但差异无统计学意义（P > 0.05）。结论 右美托咪定可有效稳定LM患者血流动力学，加强镇痛效果，减少全身麻醉用药量，改善认知功能障碍，安全有效。

Abstract:

Objective To discuss the effect of dexmedetomidine on the analgesia effect and cognitive function in patients with laparoscopic myomectomy (LM).Methods From November 2018 to November 2020, 128 patients with LM was selected, they were randomly divided into the fixed group (n = 64) and the single group (n = 64). The single group was given general anesthesia, and the fixed group was given dexmedetomidine on the basis, the hemodynamics [mean arterial pressure (MAP), heart rate (HR)], analgesic effect [visual analogue scale (VAS)], general anesthesia dosage, cognitive function (MMSE) and adverse reactions were compared between the two groups.Results The MAP, HR at anesthesia for 30 min (T₁), myomectomy (T₂), and postoperation (T₃) and the VAS at 2 h, 6 h, 12 h after operation in the fixed group were significantly lower than those in the single group (P < 0.05). The general anesthesia dosage, cognitive dysfunction rate in the fixed group were significantly lower than those in the single group, the difference were statistically significant (P < 0.05), and the MMSE scores at 12 h, 24 h and 48 h after operation in the fixed group were significantly higher than those in the single group (P < 0.05). The adverse reaction rate in the fixed group was lower than that in the single group, but there was no significant difference (P > 0.05).Conclusion Dexmedetomidine can effectively improve the hemodynamics and analgesic effect of patients with LM. It is helpful to reduce the general anesthesia dosage and improve cognitive impairment. It is safe and effective.