The Clinical Research Of Dexmedetomidine In Gynecological Tumor Laparoscopic Surgery

Objective To investigate the efficacy and safety of dexmedetomidine in gynecological cancer laparoscopic surgery.Methods Forty five ASA I ~ II level patients undergoing laparoscopic gynecological malignant tumor surgery were randomly divided into three groups(n=15),group D1(0.3ug/kg/h dexmedetomidine group)was continuous infused 0.3ug/kg/h dexmedetomidine from anesthesia induction to 30 minutes before the end of surgery,group D2(0.4ug/kg/h dexmedetomidine group)was continuous infused 0.4ug/kg/h dexmedetomidine from anesthesia induction to 30 minutes before the end of surgery,group C was the control group.Recorded systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and mean arterial pressure(MAP)of before(T1),at the end of operation(T2),before extubation(T3),extubation(T4),5min after extubation(T5),10 min after extubation(T6)and 30 min after extubation(T7);The Ramsay sedation score,Riker sedation agitation score and cough score of T3 ~ T7 were recorded;The anesthetic dosage,respiratory recovery time,recovery time,extubationtime,intraoperative bradycardia,hypotension,hypertension and the incidence of adverse reactions and postoperative respiratory depression,nausea and vomiting,chills and other adverse reactions were recorded.Results(1)Compared with group C,the dose of propofol and remifentanil of group D1 and group D2 were significantly reduced,the difference was statistically significant(P < 0.05),there was no significant difference between group D2 and group D1 in the dosage of propofol and remifentanil(P > 0.05);(2)compared with group C,the Ramsay sedation score of group D1 and group D2 at T3,T4,T5 increased,the Ramsay sedation score of group D2 at T3 ~ T7 increased,the Riker sedation agitation score of group D1 and group D2 at T3 and T4 decreased,the cough score of group D1 and group D2 at T3 decreased the difference was statistically significant(P < 0.05);Compared with group D1,the Ramsay sedation scores of group D2 at T3,T4,T5 were higher,the difference was statistically significant(P < 0.05),the Riker sedation agitation score of group D2 and the cough score of group D2 at T3 had no statistically significant differences(P > 0.05);(3)compared with group C,the SBP,DBP,MAP and HR of group D2 at T4 and the SBP,DBP of group D1 decreased,the difference was statistically significant(P < 0.05);the SBP,DBP,MAP and HR of group D1 and group D2 at T3,T4,T5 was basically lower than group C,the hemodynamics in extubation period of group D1 and group D2 is more stable than group C.(4)there was no significant difference in the incidence of adverse reactions between the three groups.Conclusion Continuous infusion of 0.3ug/kg/h and 0.4ug/kg/h dexmedetomidine during the operation of laparoscopic gynecological malignant tumor can effectively inhibit the stress of the extubation period,the more stable hemodynamics,and the sedative effect was good;The sedative effect of group0.4ug/kg/h was better than that of group 0.3ug/kg/h in the recovery period,which improved the comfort of patients during recovery period,and did not increase the incidence of adverse reactions.