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| Impacts of dexmedetomidine combined with nalbuphine used during laparoscopic total hysterectomy of patients on their postoperative situation |
| Hefei Third Clinical College of Anhui Medical University (Hefei Third People's Hospital), Anhui Province, 230022 |
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Abstract To investigate the impacts of dexmedetomidine combined with nalbuphine used during laparoscopic total hysterectomy of patients on their postoperative pain, sleep quality, cognitive function, and prostaglandin E2 (PGE2) level. Methods: 90 patients who wanted laparoscopic hysterectomy were selected and were randomly divided into two groups (45 cases in each group) from April 2020 to April 2022. The patients in the control group were given nalbuphine for analgesia, and the patients in the study group were given dexmedetomidine combined with nalbuphine for analgesia. The postoperative indicators, the pain degree evaluated by visual analog scale (VAS), the sleep quality devalued by non-rapid eye movement (NREM), rapid eye movement (REM), sleep efficiency, and subjective sleep quality, the cognitive function devalued by Mini Mental State Evaluation Scale (MMSE), the serum PGE2 level, and the occurrence of adverse reactions of the patients were compared between the two groups. Results: The extubation time (18.2±1.9min), the recovery time (16.9±1.7min), and the incidence of agitation (15.6%) of the patients in the study group were significantly lower than those (20.4±2.1min, 18.4±1.9min, and 35.6%) of the patients in the
control group. The VAS scores of the patients in both groups at 6h, 12h, and 24h after surgery had decreased gradually, and which of the patients in the study group at 12h and 24h after surgery were significantly lower than those of the patients in the control group (P＜0.05). The NREM value in N1 stage and N2 stage of the patients in both groups in 1 day and 3 days after surgery was significantly higher than that in 1 day before surgery, while the NREM value in N3 stage of the patients in the study group in 1 day and 3 days after surgery was significantly lower than that in 1 day before surgery. The NREM value in N1 stage of the patients in the study group in 3 day after surgery was significantly lower than that in 1 day after surgery, but which in N3 stage was significantly higher (all P＜0.05). There was no significant difference in the NREM value of the patients in the control group in 1 day and 3 days after surgery among different stages of NREM (P＞0.05). The REM value, the sleep efficiency, and the subjective sleep quality efficiency of the patients in the two groups in 1 day after surgery were significantly lower than those in 1 day before surgery, but which of the patients in the study group in 3 day after surgery were significantly higher than those in 1 day after surgery (all P＜0.05). There were no significant differences in the REM value, the sleep efficiency, and the subjective sleep quality efficiency of the patients in the control group among 1 day before surgery, 1 day after surgery, and 3 day after surgery (P＞0.05). The MMSE score of the patients in the two groups had increased gradually, and which of the patients in the study group in postoperative 2d and 3d were significantly higher than those of the patients in the control group (all P＜0.05). The serum PGE2 levels of the patients in the study group at 12h and 24h after surgery were all significantly lower than those at 6h after surgery. The serum PGE2 level of the patients in the control group at 6h, 12h, and 24h after surgery had decreased gradually, and which of the patients in the study group at 6h, 12h, and 24h after surgery was significantly lower than that of the patients in the control group (all P＜0.05). There was no significant difference in the incidence of adverse reactions (15.6% vs. 11.1%) of the patients between the two groups (P＞0.05). Conclusion: Dexmedetomidine combined with nalbuphine used in laparoscopic hysterectomy of the patients can effectively relieve their postoperative pain, improve their sleep quality and cognitive function, and regulate their PGE2 level, and which is safe and effective.
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