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| Effect and safety of sevoflurane combined with dexmedetomidine for general anesthesia during laparoscopic total hysterectomy |
| Air Force Medical Center, PLA, Beijing, 100142 |
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Abstract To investigate the effect and safety of sevoflurane combined with dexmedetomidine for general anesthesia during laparoscopic total hysterectomy. Methods: A total of 100 patients who wanted laparoscopic total hysterectomy were selected and randomly divided into two groups (50 cases in each group) from January 2018 to February 2021. The patients in the two groups were given general anesthesia by compound inhalation of sevoflurane. The patients in the research group were treated with intravenous infusion of dexmedetomidine, and the patients in the control group were given the same amount of normal saline. The awakening time, the extubation time, the minimum alveolar concentration for adrenergic response (MACBAR) value of sevoflurane, and the Ramsay sedation score after extubation of the patients in the two groups were observed. The heart rate (HR), the mean arterial pressure (MAP), and the sevoflurane concentrations of the patients before dexmedetomidine infusion (T0), 5 min after dexmedetomidine infusion (T1), at pneumoperitoneum established (T2), 30 min after surgery (T3), and after surgery (T4) of the patients were compared between the two groups. The adverse reactions rate during anesthesia of the patients was compared between the two groups. Results: There were significant differences in the awakening time (6.84±1.61min vs. 9.19±2.07min), the extubation time (10.83±2.16min vs.13.80±2.94min), and the MACBAR value of sevoflurane (2.49±0.85% vs. 4.64±0.97%), and the Ramsay score of extubation (3.43±0.80 points vs. 2.26±0.63 points) of the patients between the two groups (P<0.05). There were no significant differences in the values of HR and MAP of the patients at T0 between the two groups (P>0.05), and the values of HR and MAP of the patients in the research group at T1, T2, T3, and T4 were significantly lower than those of the patients in the control group (P<0.05). There was no significant difference in the sevoflurane concentration of the patients at T0 or at T1 between the two groups (P>0.05), and the sevoflurane concentration of the patients in the research group at T2, T3, or T4 was significantly lower than that of the patients in the control group (P<0.05). The incidence of adverse reactions during anesthesia (8.0%) of the patients in the research group had significant different from that (26.0%) of the patients in the control group (P<0.05). Conclusion: The general anesthesia by sevoflurane combined with dexmedetomidine during laparoscopic hysterectomy can not only reduce the dosage of sevoflurane, but also effectively stabilize the hemodynamics of the patients, which can improve the sedative and analgesic effects and can reduce the incidence of adverse reactions during the anesthesia.
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