关键词: 妇科腹腔镜手术, 右美托咪定, 年龄因素, 应激反应

Abstract: ［Abstract］ Objective〖HTSS〗To evaluate the effect of dexmedetomidine on perioperative anesthesia in patients undergoing gynecological laparoscopic surgery of different ages.
〖HTH〗〖WTHZ〗Methods〖HTSS〗A total of 105 patients, weighing 55-75 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective gynecologic laparoscopic surgery under general anesthesia, were divided into 3 groups(n=35 each)， according to age: youth group(18-44 years old), middle-aged group(45-64 years old) and elderly group(65-75 years). All patients were intravenously injected with dexmedetomidine 0.5 μg·kg-1·h-1 10 min before anesthesia induction, and then continuously pumped with 0.5 μg·kg-1·h-1 until the end of surgery. The mean arterial pressure(MAP) and heart rate(HR) were recorded at the time of admission(T0), intubation(T1), intubation 1 min(T2), intubation 5 min(T3), extubation(T4), extubation 10 min(T5), extubation 1 h(T6), and blood glucose and serum cortisol concentrations were measured at the corresponding time points. The dosage of propofol and remifentanil, respiratory recovery time, recovery time, extubation time, Ramsay score, Riker sedation/agitation score(SAS) and adverse reactions were recorded.
〖HTH〗〖WTHZ〗Results〖HTSS〗With the extension of time, MAP and HR in the three groups decreased first, then increased and then decreased. Blood glucose in the young and middle-aged groups increased first, then increased and then decreased. Blood glucose in the elderly group increased first and then decreased. Serum cortisol concentrations increased first and then decreased gradually, and the elderly group was lower than the youth group and the middle-aged group at all time points(P＜0.05). There were significant differences in interaction among the three groups, time points and time points between the groups(P＜0.05), and the propofol and fentanyl dosage reduced, Ramsay score increases, and the incidence of adverse reactions were also increased significantly in elderly group(P＜0.05). There was no statistical significance for each index in the young and middle-aged group(P＞0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Dexmedetomidine can inhibit perioperative stress response of gynecological laparoscopic surgery patients of different ages, increase sedative effect, and there are age differences. The inhibition of stress response in elderly patients is more obvious, but adverse reactions also increase. The dosage of dexmedetomidine should be adjusted according to patient′s age in the course of use.

Key words: gynecological laproscopic surgery, dexmedetomidine, age factors, stress response