Application effect on gynecological laparoscopic surgery patients by different dexmedetomidine doses / 中国医师进修杂志

ABSTRACT

Objective To analyze the application effect on gynecological laparoscopic surgery patients by different dexmedetomidine doses.Methods One hundred gynecological laparoscopic surgery patients were divided into control group and observation group by random digits table method with 50 cases each.The patients in observation group were given dexmedetomidine 0.5 μ g/kg intravenous injection 15 min before induction of anesthesia intubate,the patients in control group were given dexmedetomidine 1.0 μ g/kg,then 0.4 μ g/(kg· min) continuing venous pumping.The induction of anesthesia program in the 2 groups was midazolam,fentanyl citrate,propofol,cisatracurium besilate intravenous injection,maintaining intraoperative depth of anesthesia program was remifentanil and propofol by continuing venous pumping,and the maintaining muscle relaxation program was cisatracurium besilate interruptable injection.The patients in the 2 groups were given dezocine 0.1 mg/kg intravenous injection 30 min before the end of operation.The man-machine system engineering (MMSE) score,restlessness degree (using restlessness score),sedation effect (using Ramsay sedation score),analepsia time,extubation time and drug adverse reaction were compared.Results The rates of postoperative cognitive dysfunction and drug adverse reaction in observation group were significantly lower than those in control group [10％(5/50) vs.32％(16/50),10％(5/50) vs.40％(20/50)],Ramsay sedation score,analepsia time and extubation time were significantly lower than those in control group [(1.04 ± 0.59) scores vs.(4.84 ± 0.63) scores,(20.14 ± 4.32) min vs.(26.57 ± 4.28) min,(20.17 ± 4.23) min vs.(27.26 ± 4.34) min],there were statistical differences (P ＜ 0.05).There was no statistical difference in MMSE score before anesthesia and 24 h after anesthesia between the 2 groups (P ＞ 0.05),but MMSE score 1,6,12 h after anesthesia in observation group was significantly higher than that in control group [(23.93 ±3.51) scores vs.(20.34 ±3.45) scores,(25.87 ±4.46)scores vs.(21.34 ±4.63) scores,(27.53 ± 4.22) scores vs.(23.49 ± 4.31) scores],there was statistical difference (P ＜ 0.05).Conclusions Dexmedetomidine in accordance with 0.5 μ g/kg can reduce the incidence of postoperative drug cognitive dysfunction in the patients after gynecological laparoscopic surgery,it has good calming effect and less adverse reactions.It is worthy of popularization and application in the clinical work.