Application of anesthesia with low-dose dexmedetomidine combined with target controlled infusion propofol in hysteroscope electric resection of submucous myoma / 中国医师进修杂志

ABSTRACT

Objective To observe the safety and feasibility of low-dose dexmedetomidine combined with target controlled infusion propofol in hysteroscope electric resection of submucous myoma.Methods Eighty ASA Ⅰ-Ⅱ patients undergoing hysteroscope electric resection of submucous myoma were divided into four groups with 20 cases each by table of random digitgroup A was 0.9％ sodium chloride combined with propofol,group B was dexmedetomidine 0.25 μ g/kg combined with propofol,group C was dexmedetomidine 0.50 μ g/kg combined with propofol and group D was dexmedetomidine 1.00 μ g/kg combined with propofol.The perioperative hemedynamic changes,total dose of propofol,recovery time,rate of adverse reaction and postoperative uterine contraction pain were observed and compared among the four groups.Results When expanding the palace and electric cutting,systolic blood pressure (SBP) and heart rate (HR) in group B,C and D were significantly lower than those in group A [(107.3 ± 8.8),(108.6 ± 9.3) and (105.7 ± 8.9)mm Hg (1 mm Hg =0.133 kPa) vs.(115.1 ± 8.2) mm Hg,(109.9 ±9.6),(109.2 ± 9.5) and (106.7 ±9.1)mm Hg vs.(121.3 ± 9.9) mm Hg,(83.9 ± 6.6),(81.2 ± 7.1) and (78.7 ± 6.9) times/min vs.(91.3 ± 6.5)times/min,(84.2 ± 7.6),(83.6 ± 7.3) and (80.7 ± 6.8) times/min vs.(97.3 ± 7.2) times/min,P ＜ 0.05].The recovery time in group D was significantly longer than that in group A [(13.2 ± 3.0) min vs.(11.2 ±3.3)min,P＜ 0.05].The total dose of propofol in group C and D were significantly lower than that in group A [(289.6 ± 57.7) and (278.5 ± 56.9) mg vs.(324.6 ± 67.9) mg,P ＜ 0.05],and analgesic effect were better than group A (P ＜ 0.05).The rates of respiratory depression and recovery period restlessness in group C and D were significantly lower than those in group A [10％(2/20) and 10％(2/20) vs.20％(4/20),15％(3/20)and 20％ (4/20) vs.65％ (13/20),P ＜ 0.05],while,the rate of drowsiness after operation in group D was significantly higher than that in group A [45％(9/20) vs.10％(2/20),P＜ 0.05].Conclusions Low-dose dexmedetomidine combined with target controlled infusion propofol can be safely applied in hysteroscope electric resection of submucous myoma,and has a good analgesic effect,less adverse reaction,postoperative analgesia perfect advantages.