Efficacy of dexmedetomidine epidural anesthesia combined with nano-silver polyurethane dressing in gynecological surgery and its influence on hemodynamics, inflammatory response and postoperative recovery.

Abstract

Objective: To evaluate the effectiveness of dexmedetomidine epidural anesthesia combined with nano-silver polyurethane dressing in gynecological surgery.

Methods: This retrospective study analyzed data of 80 patients who underwent epidural anesthesia at Jinan Maternal and Child Health Care Hospital from January 2018 to May 2022. The patients treated with propofol and routine postoperative wound treatment were assigned into a control group, while the patients treated with dexmedetomidine and nano-silver polyurethane dressing were classified into an observation group. The baseline data, anesthesia effect, intraoperative basic indexes, hemodynamics indexes, postoperative recovery indexes, recovery quality, inflammatory response and adverse reactions were compared between the two groups.

Results: The observation group demonstrated a significantly higher rate of excellent and good outcomes (97.5%) compared to the control group (85.0%) (P < 0.05). The anesthesia recovery time of the observation group was notably longer than that of the control group (P < 0.05). The Ramsay score and levels of mean arterial pressure in the observation group were higher than those in the control group, while the heart rate level was significantly lower than that in the control group (all P < 0.05). The wound healing time, dressing change times and visual analogue scale (VAS) score in the observation group were obviously lower than those in the control group (all P < 0.05). The Pittsburgh sleep quality index score in the observation group was lower than that in the control group, and the 40-items quality of recovery score in the observation group was higher than that in the control group (both P < 0.05). The serum IL-6, CRP and TNF-α levels in the observation group were lower than that in the control group (all P < 0.05). The total incidence of adverse reactions in the observation group (7.5%) was significantly lower than that in the control group (25.0%) (P < 0.05).

Conclusion: In gynecological surgeries utilizing epidural anesthesia, dexmedetomidine minimally impacts hemodynamics and provides good anesthesia and sedation with a low incidence of adverse drug reactions. Nano-silver polyurethane dressing accelerates wound healing, reduces the dressing changes, alleviates the inflammatory response, and reduces the occurrence of wound infection, thereby enhancing postoperative recovery quality.