探讨右美托咪定与曲马多分别复合罗哌卡因在全麻下结肠癌根治术中的应用效果。

回顾性分析2019年1月至2020年6月四川省眉山市中医医院83例行腹腔镜下结肠癌根治性切除术患者的临床资料，其中45例予以右美托咪定复合常规全麻（A组），38例予以曲马多复合常规全麻（B组）。观察指标包括手术时间、麻醉时间、术中麻醉用药量、术中麻醉效果、术后躁动、寒战发生率、麻醉后苏醒时间及不良反应发生率。

A组右美托咪定用药剂量为（98.91±10.26）μg，B组曲马多用药剂量为（129.10±12.35） mg。两组手术时间、麻醉时间、术中咪达唑仑、丙泊酚、舒芬太尼、苯磺酸阿曲库铵用药量、麻醉后苏醒时间差异均无统计学意义（t=0.546、0.213、0.707、0.311、0.469、0.145、0.547，P=0.587、0.832、0.482、0.756、0.628、0.897、0.586）。A组麻醉效果满意率为97.78%，高于B组的84.21%（χ²=3.975，P=0.033）；A组术后躁动、寒战发生率分别为2.22%、4.44%，均分别低于B组的18.42%、26.32%（χ²=4.487、6.298，P=0.034、0.012）；A组总不良反应率低于B组（17.78% vs 60.53%, χ²=14.315，P<0.001）。

右美托咪定复合常规全麻应用于腹腔镜下结肠癌根治性切除术中，可增强术中麻醉效果，减少术后躁动和寒战发生情况，是一种合理的麻醉方法。

To explore the application of dexmedetomidine and tramadol combined with ropivacaine in the radical operation of colon cancer under general anesthesia effect.

The clinical data of 83 patients undergoing laparoscopic radical resection of colon cancer in Meishan City Hospital of Traditional Chinese Medicine from January 2019 to June 2020 were retrospectively analyzed. Among them, 45 patients were treated with dexmedetomidine combined with conventional general anesthesia (group A); the other 38 cases were treated with tramadol combined with general anesthesia (group B). The observation indexes included the operation time, anesthesia time, the amount of anesthetic drugs used during the operation, the effect of anesthesia during the operation, the incidence of postoperative restlessness, shiver, the recovery time after anesthesia and the incidence of adverse reactions.

The dosage of dexmedetomidine in group A was (98.91±10.26) μg, and the dosage of tramadol in group B was (129.10±12.35) mg. There were no significant differences in the operation time, anesthesia time, dosage of midazolam, propofol, sufentanil, cisatracurium and recovery time between the two groups (t=0.546, 0.213, 0.707, 0.311, 0.469, 0.145, 0.547, P=0.587, 0.832, 0.482, 0.756, 0.628, 0.897, 0.586). The satisfaction rate of anesthesia effect in group A was 97.78%, higher than that of 84.21% in group B (χ²=3.975, P=0.033). The incidence of postoperative agitation and chills in group A were 2.22% and 4.44%, which were lower than those of 18.42% and 26.32% in group B respectively (χ²=4.487, 6.298; P=0.034, 0.012). The adverse reaction rate in group A was lower than that in group B (17.78% vs 60.53%, χ²=14.315, P<0.001).

Dexmedetomidine combined with conventional general anesthesia in laparoscopic radical resection of colon cancer under general anesthesia can enhance the anesthetic effect during operation and reduce the occurrence of postoperative agitation and shivering, which is a reasonable anesthetic method.