Effect Of Dexmedetomidine On Pulmonary Function In Laparoscopic Hysterectomy

Objective:Laparoscopy is becoming more and more widely used in gynecological hysterectomy.Whether CO₂ pneumoperitoneum has a greater impact on lung function is worthy of further study.The purpose of this study is to observe the effect of continuous laparoscopic hysterectomy under general anesthesia and continuous infusion of dexmedetomidine for pulmonary function in patients undergoing laparoscopic hysterectomy.Methods:Eighty-eight patients who underwent laparoscopic hysterectomy under general anesthesia with tracheal intubation in the Laoshan Campus of Qingdao University Hospital from October 2017 to April 2018 were selected as subjects,age 45-65 years old,body mass index?BMI?18-30kg/m²,ASA grade I-II,randomly divided into control group?group C?and test group?group D?,40 patients in each group.After entering the room,the radialis artery puncture was performed under local anesthesia.After anesthesia-induce dintubation,group D was given dexmedetomidine 0.05?g/?kg·min?for continuous pumping,and after 10 minutes,it was changed to 0.5?g/?kg·h?dose.maintain.Group C was pumped with the same amount of normal saline at the same time as a comparison;both groups stopped the injection of dexmedetomidine hydrochloride and saline at 30 minutes before the end of the procedure.T0 was selected for anesthesia induction,T1 was 5 minutes after tracheal intubation;T2 was 5 minutes after pneumoperitoneum stabilization;T3 was 60minutes after pneumoperitoneum stabilization;T4 was 5 minutes after pneumoperitoneal termination;T5 was extubation time,a total of 6 time points,the peak airway pressure?Ppeak?at the time T1 to T4,the end-tidal carbon dioxide partial pressure?PETCO₂?and the lung compliance?Cdyn?were recorded,and the arterial blood was drawn at four time points from T1 to T4.The blood gas values of arterial partial pressure of oxygen?PaO₂?and arterial partial pressure of carbon dioxide?PaCO₂?were recorded.Finally,the values of the alveolar arterial partial pressure difference?PA-aDO₂?and respiratory index?RI?were calculated by the formula.After the completion of all data acquisition,the SPSS 17.0 statistical software system was used to observe the effect of continuous intravenous infusion of a certain amount of dexmedetomidine on the respiratory function and blood gas indexes before and after surgery.Results:There was no significant difference in the age,body mass index?BMI?operation time,anesthesia time and pneumoperitoneum time between the two groups.There was no statistically significant difference in MAP and HR between the two groups before surgery.Immediately after extubation,group MAP and HR were significantly higher in group C than in group D,and MAP and HR were compared in group D before and immediately after extubation.No significant difference.After CO₂ pneumoperitoneum,the comparison of respiratory mechanics index,Ppeak index,the two groups of patients at T2,T3 and T1 ratio increased,the difference was statistically significant,after the end of pneumoperitoneum,T4returned to T1 level,the difference was not statistical Significance;the Peak value of Group C was higher in Group D at T2 and T3,and the comparison was statistically significant.In the lung compliance index,the contrast value of group C decreased with T1 at T2,T3,and T4,and the value of group D decreased at T2,T3,T4 and T1,and the difference was statistically significant.Group C and group D at the same time point In comparison,the C group decreased more significantly at T2 and T3,and the contrast was statistically significant.In the PETCO₂ index,the patients in the two groups were significantly higher in T2,T3,T4 time and T1 time,and the difference was statistically significant.There was no statistically significant difference between the two groups at the same time point.There was no significant difference in D group between PA-aDO₂ and RI groups.T3 and T4 in group C were higher than T1.In group C,PA-aDO₂ and RI were higher than group D at T3 and T4.The difference was statistically significant.Conclusion:The results of the experiment showed that patients undergoing laparoscopic hysterectomy under general anesthesia with tracheal intubation can continuously reduce the airway pressure and improve the patient's lung compliance and gas exchange by continuously injecting a dose of dexmedetomidine intravenously.Ability,has a certain protective effect on lung function,and is conducive to the recovery of patients after surgery.