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目的探讨右美托咪定腰硬麻醉在子宫肌瘤切除术中的临床镇静效果。方法 100例子宫肌瘤切除术患者,随机分为对照组和观察组,每组50例。对照组给予瑞芬太尼麻醉,观察组给予右美托咪定腰硬麻醉,观察记录两组患者于麻醉前、手术30 min、术后时的心率(HR)、脑电双频指数(BIS)、镇静评分标准(Ramsay评分)以及术中、术后不良反应的发生情况。结果观察组术中HR、BIS比麻醉前及对照组均低,差异有统计学意义(P<0.05),观察组术中Ramsay评分比麻醉前及对照组高,差异有统计学意义(P<0.05);观察组术中、术后的躁动、恶心、呕吐等不良反应的发生率为10.0%,略高于对照组的8.0%,但两组比较差异无统计学意义(χ2=0.3854,P=0.5348>0.05)。结论右美托咪定腰硬麻醉应用于子宫肌瘤切除术中的镇静效果显著,不良反应发生率较低,安全可靠,值得临床推广应用。
Objective To investigate the clinical sedation effect of dexmedetomidine and lumbar spinal anesthesia in myomectomy. Methods 100 cases of myomectomy patients were randomly divided into control group and observation group, 50 cases in each group. The control group was given remifentanil anesthesia, and the observation group was given dexmedetomidine and spinal anesthesia. Before the anesthesia, the patients in the observation group were anesthetized for 30 min, the heart rate (HR), the bispectral index (BIS ), Sedation score (Ramsay score) as well as intraoperative and postoperative adverse reactions. Results The intraoperative HR and BIS in the observation group were significantly lower than those before anesthesia and in the control group (P <0.05). The Ramsay score in the observation group was significantly higher than that before anesthesia and in the control group (P < 0.05). The incidence of postoperative adverse reactions such as agitation, nausea and vomiting in the observation group was 10.0%, slightly higher than 8.0% in the control group, but there was no significant difference between the two groups (χ2 = 0.3854, P = 0.5348> 0.05). Conclusion The application of dexmedetomidine and lumbar spinal anesthesia in the treatment of myomectomy has obvious sedation effect, low incidence of adverse reactions, safe and reliable, and is worthy of clinical application.