Effects of dexmedetomidine on pain and hemodynamics in patients undergoing laparoscopic myomectomy
Objective To investigate the effects of dexmedetomidine on pain and hemodynamics in patients undergoing laparoscopic myomectomy(LM).Methods A total of 104 patients with LM admitted to 521 Hospital of Nornico Group Xi'an from January 2020 to December 2022 were retrospectively selected as the study objects,and were divided into the observation group(52 cases)and the control group(52 cases)according to different anesthesia methods.The control group was given Sufentanil,and the observation group was given dexmedetomidine on the basis of the control group.Both groups were followed up and observed for 3 d after surgery.Sleep quality of before surgery(T0)and 24 h after surgery(T5),and the level of stress index,mechanical pain threshold,cognitive function,hemodynamic at different time points,and the occurrence of adverse reactions at 3 d after surgery were compared between the two groups.Results The scores of Pittsburgh Sleep Quality Inventory(PSQI)in both groups were higher in T5 than T0 in both groups,and the control group was higher than the observation group(P<0.05).The level of serum interleukin-6(IL-6),norepinephrine(NE)and malondialdehyde(MDA)in the two groups at anesthesia for 30 min(T2),T5 firstly increased and then decreased compared with T0,while the level of serum angiotensin-Ⅱ(Ang-Ⅱ)at T2,T5 increased compared with T0,and the level of serum IL-6,NE,MDA and Ang-Ⅱ in T2 and T5 of the control group were higher than those of the observation group(P<0.05).The mechanical pain threshold and the score of Mini-Mental State Examination(MMSE)in the two groups at 12 h after surgery(T4),T5 firstly decreased and then increased compared with T0,and the control group was lower than the observation group at T4 and T5(P<0.05).The level of heart rate(HR)and blood mean arterial pressure(MAP)in the two groups at endotracheal intubation for5 min(T1),T2,after surgery(T3)showed a gradually increasing trend compared with that at T0,and the levels of the control group at T1,T2,and T3 were higher than those of the observation group(P<0.05).The level of cardiac index(CI)in the two groups at T1,T2,T3 firstly decreased and then increased compared with that at T0,and the levels of CI in the control group at T1,T2,and T3 were lower than that of the observation group(P<0.05).The level of central venous pressure(CVP)in the two groups at T1,T2,T3 decreased compared with that at T0,the level of CVP in the control group at T3 was higher than that of the observation group(P<0.05).The occurrence of adverse reactions within 3 d after surgery in the observation group was lower than that in the control group(P<0.05).Conclusion Patients with LM anesthetied with dexmedetomidine had little effect on sleep quality,cognitive function and hemodynamics,and could reduce the body's stress response,improve the mechanical pain threshold,and had less adverse reactions,with certain safety.
laparoscopic myomectomydexmedetomidinestress responsemechanical pain thresholdhemodynamiccognitive function
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