Clinical Application Of Dexmedetomidine Combined With Flurbiprofen In Patients Undergoing Hysteroscopic Surgery

Objective:To observe the clinical effect of dexmedetomidine combined with flurbiprofen ester in hysteroscopic surgery,so as to provide a reference for clinical anesthesia.Method:A number of 120 patients selected for hysteroscopic surgery in the First Affiliated Hospital of Guangxi Medical University from March to December 2019.All patients were aware of the study and signed anesthesia consent forms.Patients were randomly divided into four groups（n=30）:control group,dexmedetomidine group,flurbiprofen group and dextromet-flurbiprofen group.Control group,dexmedetomidine group,flurbiprofen group and dextromet-flurbiprofen group were preoperative 15 min intravenous drip 1.25 ml/kg 0.9%sodium chloride,intravenous drip of 1.0ml/kg of 0.9%sodium chloride and vein pump 0.5μg/kg dexmedetomidine,intravenous drip 1.0 mg/kg flurbiprofen ester and vein pump 0.25 ml/kg 0.9%sodium chloride injection,intravenous injection pump 0.5μg/kg dexmedetomidine and intravenous drip of 1.0 mg/kg flurbiprofen ester.Four groups were induced by intravenous injection of 1.0μg/kg fentanyl citrate and plasma target-controlled infusion of propofol.Propofol injection pain was assessed by a four-level scale.The satisfaction score of the operator was recorded.The number of patients with adverse reactions such as respiratory depression,hypotension,nausea,vomiting,agitation,and postoperative analgesics were recorded.The VAS score was used to assess the degree of pain when the patient was awake.To record the time when the patient’s consciousness disappeared,the plasma concentration of propofol when the patient’s consciousness disappeared,the dosage of propofol when the consciousness disappeared,the total amount of propofol during the operation,the operation time and the waking time.Systolic pressure（SBP）,diastolic pressure（DBP）,mean arterial pressure（MAP）,heart rate（HR）and respiratory rate（RR）were recorded at entry（T₁）,expansion of the uterine mouth（T₂）,and at the end of surgery（T₃）.Result:（1）Compared with the control group,patients in the dexmedetomidine group and dextromet-flurbiprofen group had shorter time of consciousness disappearance.Compared with the flurbiprofen group,patients in the dextromet-flurbiprofen group and the dextromet-flurbiprofen group had shorter consciousness loss time（P<0.05）.There was no significant difference in consciousness disappearance time between flurbiprofen group and control group（P>0.05）.Compared with the control group,propofol plasma concentrations were lower in the dexmedetomidine group,the flurbiprofen group and the dextromet-flurbiprofen group when consciousness disappeared.Compared with flurbiprofen group,propofol plasma concentration was low when consciousness disappeared in the dexmedetomidine group and dextromet-flurbiprofen group（P<0.05）.There was no significant difference in propofol plasma concentration when consciousness disappeared between the dextromet-flurbiprofen group and the dexmedetomidine group（P>0.05）.Compared with the control group,the amount of propofol was less when the consciousness disappeared in the dexmedetomidine group and dextromet-flurbiprofen group.Compared with the dexmedetomidine group,patients in the dextromet-flurbiprofen group had less propofol when consciousness disappeared（P<0.05）.There was no significant difference in propofol dosage between flurbiprofen group and control group when consciousness disappeared（P>0.05）.Compared with the control group,the total amount of propofol was lower in the dexmedetomidine group,flurbiprofen group and dextromet-flurbiprofen group（P<0.05）.There was no significant difference in the total amount of propofol between the dextromet-flurbiprofen group,the dexmedetomidine group and the flurbiprofen group（P>0.05）.The wake time of patients in the dextromet-flurbiprofen group was longer than that in the dexmedetomidine group and the control group（P<0.05）.There was no significant difference in the wake time between the control group,dexmedetomidine group and flurbiprofen ester group（P>0.05）.Compared with the control group,VAS scores of patients in flurbiprofen group and dextromet-flurbiprofen group were lower when they woke up.Compared with the dexmedetomidine group,the VAS score of the resuscitated patients in the dextromet-flurbiprofen group was lower（P<0.05）.VAS scores of resuscitated patients showed no statistically significant difference between the dexmedetomidine group and the control group,between the dexmedetomidine group and the flurbiprofen group,between dextromet-flurbiprofen and flurbiprofen group（P>0.05）.（4）1)HR There was no significant difference in HR between T1,T2 and T3 in the control group（P>0.05）.HR at T₂and T₃in the dexmedetomidine group was lower than that at T₁（P<0.05）.HR at T₂and T₃in the dexmedetomidine group was lower than that in the control group（P<0.05）.There was no significant difference in HR at T1,T2 or T3 between flurbiprofen group（P>0.05）.HR at T₂and T₃in dextromet-flurbiprofen group was lower than that at T₁（P<0.05）.HR at T₁in dextromet-flurbiprofen group was lower than that in dexmedetomidine group（P<0.05）.HR at T₂and T₃in dextromet-flurbiprofen group was lower than that in control group and flurbiprofen group at the same time point（P<0.05）.HR at T₁in dextromet-flurbiprofen group was lower than that in the control group（P<0.05）.2)RR There was no significant difference between T1,T2 and T3 RR in the control group（P>0.05）.There was no significant difference in RR between T1,T2 and T3 in the right beauty group（P>0.05）.The T₃RR of the dexmedetomidine group was lower than that of the control group（P<0.05）.T₃RR of flurbiprofen group was lower than T₂RR（P<0.05）.T₂RR was lower than T₁RR in dextromet-flurbiprofen group（P<0.05）.The T₂and T₃RR of the dextromet-flurbiprofen group were lower than those of the control group at the same time point（P<0.05）.3)SBP in the control group,SBP at time T₂was lower than that at time T₁（P<0.05）.SBP was lower at T₂and T₃than at T₁in the dexmedetomidine group（P<0.05）.SBP at T₂and T₃in flurbiprofen group was lower than that at T₁（P<0.05）.The SBP of dextromet-flurbiprofen at T₂and T₃was lower than that of T₁（P<0.05）.SBP of dextromet-flurbiprofen group at T₂and T₃was lower than that of the control group at the same time point（P<0.05）.4)DBP DBP at Time T₂in the control group was lower than that at time T₁（P<0.05）.DBP at T₂and T₃in dexmedetomidine group was lower than that at T₁（P<0.05）.DBP at T₂and T₃in the dexmedetomidine group was lower than that at the same time point in the control group（P<0.05）.DBP at T₂and T₃in flurbiprofen group was lower than that at T₁（P<0.05）.DBP at T₂and T₃in dextromet-flurbiprofen group was higher than that at T₁（P<0.05）.DBP at T₃in dextromet-flurbiprofen group was lower than that in the control group（P<0.05）.5)MAP In the control group,time MAP of T₂was lower than that of T₁（P<0.05）.The MAP of T₂and T₃in dexmedetomidine group was lower than that of T₁（P<0.05）.The MAP of T₂and T₃time points in the dexmedetomidine group was lower than that of the control group（P<0.05）.The MAP of T₂and T₃time points in flurbiprofen group was lower than that of T₁（P<0.05）.The MAP of T₂and T₃time points in flurbiprofen group was lower than that of T₁（P<0.05）.The MAP of T₂and T₃time points in dextromet-flurbiprofen group was lower than that of T₁（P<0.05）.The MAP of T₂and T₃timepoints in dextromet-flurbiprofen group was lower than that of the control group（P<0.05）.Conclusion:Dexmedetomidine combined with flurbiprofen can be used in anesthesia for hysteroscopic surgery,which can improve the analgesic effect of patients,reduce the use of propofol and opioids,stabilize the patient’s recovery,and do not increase the incidence of adverse reactions,providing a certain reference for clinical anesthesia.