CAJ | 학술논문

目的观察右美托咪定对甲状腺手术患者全身麻醉拔管反应的影响.方法择期全凭静脉麻醉下行甲状腺手术患者42例,ASA分级Ⅰ～Ⅱ级,按随机数字表法将患者分为两组:右美托咪定组和对照组,每组21例.两组麻醉诱导和维持相同,右美托咪定组于麻醉诱导前15 min静脉泵注右美托咪定0.6μg/kg( 10 min泵注完毕),术中继之以0.4μg/(kg·h)持续泵注；对照组以同样方式泵注等量0.9％氯化钠.记录患者收缩压、舒张压和心率变化,手术时间,苏醒时间,拔管时间,定向力恢复时间,恢复至Aldrete改良评分≥9分时间,苏醒时耐管评分,苏醒期躁动率及不良反应.结果两组患者手术时间、苏醒时间、拔管时间、定向力恢复时间和恢复至Aldrete改良评分≥9分时间比较差异无统计学意义(P＞0.05).右美托咪定组拔管即刻及拔管后1、3、5 min时收缩压、舒张压、心率低于同时点对照组(P＜ 0.05或＜0.01).右美托咪定组患者苏醒时耐管评分优良率[95.2％(20/21)]明显高于对照组[28.6％ (6/21)] (P＜ 0.05),苏醒期躁动率(0)明显低于对照组[28.6％(6/21) ](P＜ 0.05).两组苏醒期均无不良反应发生.结论麻醉诱导前静脉泵注右美托咪定0.6μg/kg( 10 min泵注完毕),术中继之以0.4μg/(kg·h)持续泵注可有效降低甲状腺手术患者拔管期的心血管反应,增强患者气管导管耐受性,降低患者苏醒期躁动率,有利于患者平稳舒适苏醒.
목적 관찰우미탁미정대갑상선수술환자전신마취발관반응적영향.방법 택기전빙정맥마취하행갑상선수술환자42례,ASA분급Ⅰ～Ⅱ급,안수궤수자표법장환자분위량조:우미탁미정조화대조조,매조21례.량조마취유도화유지상동,우미탁미정조우마취유도전15 min정맥빙주우미탁미정0.6μg/kg( 10 min빙주완필),술중계지이0.4μg/(kg·h)지속빙주；대조조이동양방식빙주등량0.9％록화납.기록환자수축압、서장압화심솔변화,수술시간,소성시간,발관시간,정향력회복시간,회복지Aldrete개량평분≥9분시간,소성시내관평분,소성기조동솔급불량반응.결과 량조환자수술시간、소성시간、발관시간、정향력회복시간화회복지Aldrete개량평분≥9분시간비교차이무통계학의의(P＞0.05).우미탁미정조발관즉각급발관후1、3、5 min시수축압、서장압、심솔저우동시점대조조(P＜ 0.05혹＜0.01).우미탁미정조환자소성시내관평분우량솔[95.2％(20/21)]명현고우대조조[28.6％ (6/21)] (P＜ 0.05),소성기조동솔(0)명현저우대조조[28.6％(6/21) ](P＜ 0.05).량조소성기균무불량반응발생.결론 마취유도전정맥빙주우미탁미정0.6μg/kg( 10 min빙주완필),술중계지이0.4μg/(kg·h)지속빙주가유효강저갑상선수술환자발관기적심혈관반응,증강환자기관도관내수성,강저환자소성기조동솔,유리우환자평은서괄소성.
Objective To investigate the effect of dexmedetomidine on tracheal extubation response in patients undergoing thyroid surgery after general anesthesia.Methods Forty-two patients who ASA classification Ⅰ - Ⅱ,were performed thyroid surgery under total intravenous anesthesia.They were divided into dexmedetomidine group and control group by random number table with 21 cases each.Both groups patients anesthesia induction and maintenance with the same methods,dexmedetomidine group patients at 15 min before anesthesia induction with venous infusion dexmedetomidine 0.6 μ g/kg (finished 10 min infusion),followed by 0.4 μ g/(kg · h) continuous infusion,control group patients with pump equivalent in 0.9％ sodium chloride injection in the same way.Systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR),surgery time,recovery time,extubation time,orientation recovery time,modified Aldrete score ≥9 scores time,rate of recovery from restlessness,tolerance score and recovery from any adverse effects were recorded.Results There were no significant differences between two groups in surgery time,recovery time,extubation time,orientation recovery time,modified Aldrete score ≥ 9 scores time (P ＞0.05).SBP,DBP,HR at immediately and after extubation with 1,3,5 min of dexmedetomidine group were lower than those of control group (P ＜ 0.05 or ＜ 0.01 ).Tolerance score excellent rate of dexmedetomidine group was higher than that of control group [95.2％ (20/21) vs.28.6％ (6/21)] (P ＜ 0.05),the rate of recovery from restlessness of dexmedetomidine group was lower than that of control group [0 vs.28.6％(6/21 ) ] (P ＜ 0.05).Conclusion Before anesthesia induction in patients with venous infusion dexmedetomidine 0.6 p g/kg(finished 10 min infusion),followed by 0.4 p g/(kg·h) continuous infusion can effectively reduce the patients' cardiovascular response to extubation,strengthen the patients' tolerance to endotracheal tube,reduce the patients' agitation and recover consciousness comfortable.