CAJ | 학술논문

目的：评价右美托咪定在宫腹腔镜联合手术患者的镇痛疗效与安全性。方法90例行宫腹腔镜联合手术的患者随机分为3组：对照组（C组）、右美托咪定1组（ D1组）和2组（ D2组）。 D1、D2组，麻醉诱导后10 min，静脉泵入右美托咪定0.4μg· kg－1；C组给等量0.9％NaCl溶液。记录围术期循环指标、脑电双频谱指数（BIS）、手术时间、拔管时间，用视觉模拟评分法（VAS）评估手术后2，4，12，24 h的疼痛程度，并记录不良反应及镇痛药物使用情况。结果 D1、D2组循环指标较C组稳定，BIS值低于C组。 D1组拔管时间长于C组，D2组拔管时间与C组差异无统计学意义。 D1、D2组患者VAS低于C组，不良反应少，使用镇痛药物例数少。结论宫腹腔镜联合手术患者静脉泵注右美托咪定0.4μg· kg－1可节俭麻醉维持药物，不延长拔管时间，减轻术后疼痛，降低不良反应发生率，减少术后镇痛药物的用量。
목적：평개우미탁미정재궁복강경연합수술환자적진통료효여안전성。방법90례행궁복강경연합수술적환자수궤분위3조：대조조（C조）、우미탁미정1조（ D1조）화2조（ D2조）。 D1、D2조，마취유도후10 min，정맥빙입우미탁미정0.4μg· kg－1；C조급등량0.9％NaCl용액。기록위술기순배지표、뇌전쌍빈보지수（BIS）、수술시간、발관시간，용시각모의평분법（VAS）평고수술후2，4，12，24 h적동통정도，병기록불량반응급진통약물사용정황。결과 D1、D2조순배지표교C조은정，BIS치저우C조。 D1조발관시간장우C조，D2조발관시간여C조차이무통계학의의。 D1、D2조환자VAS저우C조，불량반응소，사용진통약물례수소。결론궁복강경연합수술환자정맥빙주우미탁미정0.4μg· kg－1가절검마취유지약물，불연장발관시간，감경술후동통，강저불량반응발생솔，감소술후진통약물적용량。
Objective To investigate the effects of dexmedetomidine on patients undergoing combined hysteroscopy and laparoscopy . Methods Ninety patients undergoing combined hysteroscopy and lapa-roscopy were randomly divided into control group ( C ) , dexmedetomidine group1 ( D1 ) and dexmedetomidine group 2 ( D2 ) , with thirty patients each.Dexmedetomidine 0.4 μg · kg -1 was injected in each patient in group D1 and D2 intravenously in 10 min by infusing pump after induc-tion of anesthesia , while an equal volume of 0.9%NaCl was administered to patients in group C.Peri-operative mean arterial pressure (MAP), heart rate ( HR) , bispectral index ( BIS ) , operation time , and extuba-tion time were recorded.The intensity of pain was valued using visual analogue scale ( VAS) at 2, 4, 12, 24 h after operation.The adverse effects and the usage of analgesic drugs were recorded.Results Hemo-dynamic parameters were more stable during operation in group D 1 and D2 than those in group C , and BIS of group D1 and D2 were lower than that of group C.Extubation time of group D 1 was longer than that in group C , while there was no significant difference in extubation time be-tween group D2 and C.Compared with group C ,the data of VAS in group D1 and D2 were decreased , with less adverse reaction and usage of anal-gesic drugs.Conclusion Dexmedetomidine 0.4 μg · kg -1 injected intravenously can reduce the doses of drugs for anesthesia maintenance in patients undergoing combined hysteroscopy and laparoscopy , without a prolongation of extubation time , but can release postoperative pain , decrease the incidence of nausea , vomiting and shivering , and will save postoperative analgesics.