Application effect of remifentanil and dexmedetomidine combined with general anesthesia in the treatment of upper urinary tract calculi with flexible ureteroscopic lithotripsy
Application effect of remifentanil and dexmedetomidine combined with general anesthesia in the treatment of upper urinary tract calculi with flexible ureteroscopic lithotripsy
Objective To study the application effect of remifentanil and dexmedetomidine combined with general anesthesia in the treatment of upper urinary tract calculi with flexible ureteroscopic lithotripsy.Methods A total of 80 patients with upper urinary tract calculi who underwent flexible ureteroscopic lithotripsy in our hospital were divided into remifentanil group(RF group,n=40)and remifentanil and dexmedetomidine group(RF+YM group,n=40)by random number table method.The same anesthesia induction regimen was used in the two groups.In the maintenance of anesthesia,the RF group solely used remifentanil,while the RF+YM group used a combination of remifentanil and dexmedetomidine.The mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SaO2)of the two groups were detected at the time of entering the room(T0),tracheal intubation(T1),30 minutes after the beginning of the operation(T2)and extubation(T3).Blood lactic acid,blood glucose and pH value were detected before operation and 30 minutes after operation.Serum oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)]were detected before and 2 h after operation.Results In the intra-group comparison,MAP and HR at T1,T2 and T3 in the RF group were higher than those at T0(P<0.05),and SaO2 at T1,T2 and T3 was lower than that at T0(P<0.05).In RF+YM group,MAP and HR at T1 and T3 were higher than those at T0(P<0.05),and SaO2 at T1,T2 and T3 were lower than that at T0(P<0.05).In the comparison between groups,the MAP and HR of RF group at T2 and T3 were higher than those of RF+YM group(P<0.05),and the SaO2 of T3 was lower than that of RF+YM group(P<0.05).At 30 minutes after the beginning of the operation,the blood lactic acid and blood glucose in the RF+YM group were lower than those in the RF group,and the pH value was higher than that in the RF group(P<0.05).At 2 h after operation,serum SOD in RF+YM group was higher than that in RF group,and serum MDA was lower than that in RF group(P<0.05).Conclusion In the treatment of patients with upper urinary tract calculi undergoing flexible ureteroscopic lithotripsy,remifentanil and dexmedetomidine combined with general anesthesia can better maintain the stability of hemodynamics,reduce oxidative stress injury,maintain the homeostasis of the patient's internal environment,and reduce the risk of operation.
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