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| Dose-effect study of dexmedetomidine combined with etomidate for anesthesia during hysteroscopic and laparoscopic surgery of patients with tubal infertility and the changes of stress factor levels |
1. Tangshan Second Hospital, Tangshan, Hebei Province, 063015；2. Cang County Hospital, Hebei Province；
3.Tang County People's Hospital (The Fourth Central Hospital of Baoding City), Baoding, Hebei Province |
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Abstract To explore the dose-effect study of dexmedetomidine combined with etomidate for anesthesia during hysteroscopic and laparoscopic surgery of patients with tubal infertility, and to analyze the changes of the stress factor levels of the patients. Methods: 160 patients with tubal infertility who wanted hysteroscopic and laparoscopic surgery were selected and were divided into four groups (40 cases in each group) according to the random number table method from June 2018 to April 2021. The patients in group A were given etomidate combined with low-dose dexmedetomidine for anesthesia during surgery, the patients in group B were given etomidate combined with medium-dose dexmedetomidine for anesthesia during surgery, the patients in group C were given etomidate combined with high-dose dexmedetomidine for anesthesia during surgery, and the patients in group D were given etomidate for anesthesia alone during surgery. The clinical indicators, the hemodynamic indicators, and the stress factors levels of the patients before and after intervention were compared among the four groups. The adverse reactions of the patients in the four groups were recorded. Results: The extubating time and recovery time of the patients in group C were significantly higher than those of the patients in the other three groups. The DBP and SBP levels of the patients in group A, group B, and group C at T2 were significantly lower than those of the patients in group D, and those of the patients in groups B and C at T3 and T4 were significantly lower than those of the patients in group D. The MAP and HR levels of the patients in group D and group A at T3 and T4 were significantly lower than those of the patients at T1 and T2. The MAP and HR levels of the patients in group A and group B and C at T3 and T4 were significantly lower than those of the patients in group D. The levels of COR and ADR of the patients in group D at T3 and T4 were significantly higher than those of the patients at T1, and those of the patients in group A, group B, and group C were significantly lower than those of the patients in group D, and which of the patients in group B and group C at T4 were significantly lower than those of the patients in group A (all P＜0.05). There was no patient with serious adverse reaction in the four groups after surgery. The incidences of rapid heart rate and high blood pressure of the patients in group D and group A were significantly higher than those of the patients in group B and group C, and which of the patients in group C were significantly higher than those of the patients in group D, group A, and group B. The total incidence of adverse reactions of the patients in group B was significantly lower than that of the patients in the other three groups (all P＜0.05). Conclusion: The medium-dose dexmedetomidine combined with etomidate for anesthesia during hysteroscopic and laparoscopic surgery of the patients with tubal infertility has fewer adverse reactions with the highest safety, and which can effectively improve the clinical indicators and hemodynamic indicators, and can alleviate the stress response of the patients.
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