CAJ | 학술논문

目的：探讨右美托咪定用于妇科腔镜手术的安全性和有效性。方法选择2014年2～10月择期行腹腔镜下子宫肌瘤／卵巢囊肿剥除术患者60例，使用随机数表法分为右美托咪定组（ D组）和生理盐水组（ N组）各30例。 D组于麻醉诱导前15 min静脉泵注右美托咪定1μg／kg后，以0．2μg／（ kg?h）维持至停气腹；N组则泵注等容积生理盐水。两组均以丙泊酚、舒芬太尼、苯磺顺阿曲库铵维持麻醉。比较两组患者入室时（ T0）、气管插管时（ T1）、气管插管后3 min （ T2）、切皮时（ T3）及拔管时（ T4）的血压（ BP）、心率（ HR）以及术中维持麻醉时丙泊酚的用量和拔管时间及拔管后5、30、60 min的镇静状态。结果 D组较N组T1～T4各时间点BP明显降低、HR明显减慢；丙泊酚用量明显减少；术后镇静状态明显好于N组，差异有统计学意义（ P＜0．05）。结论妇科腔镜手术应用右美托咪定可使患者的血流动力学更稳定，术后苏醒迅速而完全。
목적：탐토우미탁미정용우부과강경수술적안전성화유효성。방법선택2014년2～10월택기행복강경하자궁기류／란소낭종박제술환자60례，사용수궤수표법분위우미탁미정조（ D조）화생리염수조（ N조）각30례。 D조우마취유도전15 min정맥빙주우미탁미정1μg／kg후，이0．2μg／（ kg?h）유지지정기복；N조칙빙주등용적생리염수。량조균이병박분、서분태니、분광순아곡고안유지마취。비교량조환자입실시（ T0）、기관삽관시（ T1）、기관삽관후3 min （ T2）、절피시（ T3）급발관시（ T4）적혈압（ BP）、심솔（ HR）이급술중유지마취시병박분적용량화발관시간급발관후5、30、60 min적진정상태。결과 D조교N조T1～T4각시간점BP명현강저、HR명현감만；병박분용량명현감소；술후진정상태명현호우N조，차이유통계학의의（ P＜0．05）。결론부과강경수술응용우미탁미정가사환자적혈류동역학경은정，술후소성신속이완전。
Objective To investigate the safety and efficacy of demnedetomidine in patients undergoing gynecological laparo -scopic surgeries.Methods Sixty patients with ASA physical grade I or II undergoing elective gynecological laparoscopic surgeries were randomly divided into two groups with 30 each: group D and group N .Group D respectively received dexmedetomidine 1μg/kg fifteen minutes before the operation and 0.2μg/kg.h to the end of the operation by ways of intravenous infusion .norrnal saline in Group N.The maintainence of anesthesia used by Propofol ,sufentanil,benzene sulfonyl cis-atracurium in both two groups.Blood pressure, heart rate,The amount of propofol and the time of extubation were recorded at the time of entering the operating room (T0),Intubation ( T1 ) ,3 min after intubation ( T2 ) , skin incision ( T3 ) and extubation ( T4 ) .The incidence of agitation and sedation scores were as-sessed at 5,30,60 min after extubation.Results Compared with group D at the time of T1 ~T4,the blood pressure and heart rate of group N were significantly decreased ( P<0.05 ) .the amount of propofol in group D were reduced .The score of Ramsay were higher at 5,30 min after extubation in group D than in group N (P<0.05).Conclusion Dexmedetomidine can make patients’hemodynamics more stable and the recovery more rapid and complete .