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| Application of Dexmedetomidine Combined with Remifentanil in Anesthesia of Gynecological Daytime Operation |
| GAO Jian-xin, YU Ke, YANG Wei-tao |
| Changsha maternal and child health care hospital,Changsha Hunan 410007 |
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Abstract 【Objective】 To observe the anesthesia effect of dexmedetomidine combined with remifentanil in gynecological daytime operation.【Methods】 One hundred cases of gynecological day surgery were selected,and were divided into dexmedetomidine combined with remifentanil group (observation group) and propofol group (control group) according to the random number table method. Both groups were treated with plasma concentration target controlled infusion of intravenous anesthesia (TCI), the observation group with dual-channel target controlled infusion of dexmedetomidine (plasma target concentration 0.3 ng/mL) and remifentanil (plasma target concentration 1.5 ng/mL), and the control group with target controlled infusion of propofol (plasma target concentration 3.0μg/mL). When the patient showed body movement during operation, the observation group was injected with remifentanil and the control group with propofol until body movement disappeared.The mean arterial pressure (map), blood oxygen saturation (SpO2), heart rate (HR) of patients before anesthesia induction (T1), before operation (T2), during operation (T3) and during recovery (T4) were recorded; the physical activity of patients during operation was recorded; the respiratory inhibition (SpO2 < 90% or apnea > 15s) was recorded ;and the recovery time (from the end of operation to wake up and open eyes, handshake according to instructions) and the occurrence of postoperative uterine contraction pain (VAS score) were recorded, and the time from drug withdrawal to anesthesia induction in the two groups were recorded.【Results】 There was no significant difference in map, SpO2 and HR between the two groups at T1 and T3 (P>0.05); map, SpO2 and HR in the observation group at T2 were significantly higher than those in the control group (P<0.05); The MAP and HR in the control group at T4 were significantly higher than those in the observation group (P<0.05), but there was no significant difference in SpO2 between the two groups (P>0.05). The number of body movement of patients in the observation group was significantly less than that in the control group (P<0.05), and the recovery time was significantly shorter than that in the control group (P<0.05), but there was no significant difference in the incidence of respiratory inhibition between the two groups (P>0.05). The time of anesthesia induction in the observation group was longer than that in the control group (P<0.05). 【Conclusion】 In the gynecological daytime operation, dexmedetomidine combined with remifentanil has a definite anesthesia effect, can obviously reduce the postoperative uterine contraction pain, shorten the recovery time and quality of patients, and improve the comfort of patients and operation.However, it is more expensive and longer than propofol.For the patients with propofol contraindications in gynecological daytime surgery, the combination of dextromethoridine and remifentanil anesthesia is an appropriate choice.
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Received: 06 January 2020
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2020, Vol. 37 
