【摘要】：目的 :比較丙泊酚與右美托咪定在腹腔鏡下盆腔膿腫清除術(shù)中的全身麻醉效果及安全性。方法:將136例擬行盆腔膿腫清除術(shù)的女性患者隨機(jī)均分為丙泊酚組和右美托咪定組。丙泊酚組患者采用DIPRIFUSOR靶控輸注系統(tǒng)注入丙泊酚注射液,初始血藥濃度為0.5 mg/L,等待與效應(yīng)室濃度平衡后,以0.3 mg/L維持血藥濃度并逐漸遞增至適宜的鎮(zhèn)靜深度,于關(guān)閉腹膜時(shí)停止給予丙泊酚。右美托咪定組患者給予鹽酸右美托咪定注射液0.5μg/kg泵注10 min,并以0.5μg/(kg·h)持續(xù)泵注,于腹腔沖洗前停止泵注右美托咪定。觀察兩組患者意識(shí)消失時(shí)間、意識(shí)恢復(fù)時(shí)間,輸入鎮(zhèn)靜藥物前(T1)、術(shù)中30 min(T2)、手術(shù)完畢患者清醒后(T3)不同時(shí)間點(diǎn)的腦電雙頻指數(shù)(BIS)及不良反應(yīng)發(fā)生情況。結(jié)果:右美托咪定組患者意識(shí)消失時(shí)間、意識(shí)恢復(fù)時(shí)間均顯著短于丙泊酚組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者T1、T3時(shí)的BIS比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者T2時(shí)的BIS均顯著低于同組T1、T3時(shí),且右美托咪定組低于丙泊酚組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。右美托咪定組患者不良反應(yīng)發(fā)生率顯著低于丙泊酚組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:右美托咪定用于腹腔鏡下盆腔膿腫清除術(shù)的麻醉效果較丙泊酚好,且安全性較好。
[Abstract]:Objective: to compare the effect and safety of propofol and dexmetomide in laparoscopic pelvic abscess removal. Methods: 136 female patients undergoing pelvic abscess removal were randomly divided into propofol group and dexteromide group. Propofol patients in propofol group were injected with propofol injection with DIPRIFUSOR target-controlled infusion system. after the initial blood concentration was 0.5 mg/L, and the concentration of effect chamber was balanced, the plasma concentration was maintained at 0.3 mg/L and gradually increased to a suitable sedation depth. Propofol was stopped when the peritoneum was closed. The patients in the right metomidin group were injected with 0.5 渭 g / kg hydrochloric acid injection for 10 min, and 0.5 渭 g / (kg 路h) for continuous infusion, and the right metomipramine injection was stopped before intraabdominal flushing. The time of consciousness disappearance, the time of consciousness recovery, the occurrence of EEG bispectral index (BIS) and adverse reactions at different time points after awake (T3) were observed before injection of sedation (T1), 30 min (T2) during operation. Results: the consciousness disappearance time and consciousness recovery time of the patients in the right metomipramine group were significantly shorter than those in the propofol group, and there was significant difference between the two groups (P 0.05). There was no significant difference in BIS between the two groups at T 1 and T 3 (P 0.05). The BIS of the two groups at T2 was significantly lower than that of the same group T1, T3, and the right metomidate group was lower than that of propofol group, the difference was statistically significant (P 0.05). The incidence of adverse reactions in dexmetomide group was significantly lower than that in propofol group, and there was significant difference between the two groups (P 0.05). Conclusion: the anesthetic effect and safety of dexmetomide in laparoscopic pelvic abscess removal are better than those of propofol.
【作者單位】： 嵊州市人民醫(yī)院麻醉科;
【分類號(hào)】：R614
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本文編號(hào)：2524536