CAJ | 학술논문

目的观察静脉输注右美托咪定能否抑制舒芬太尼引起的呛咳反应.方法选择颅内肿瘤切除术患者90例,按随机数字表法分为观察组和对照组,每组45例.观察组麻醉诱导前静脉输注0.5 μg/kg右美托咪定,对照组静脉输注等容量0.9％氯化钠,两组均10 min输注完毕.给予负荷剂量后,两组均在3s内静脉注射0.3 μg/kg舒芬太尼,观察舒芬太尼给药后1 min内呛咳发生情况.记录静脉输注右美托咪定或0.9％氯化钠前(T0)、静脉输注右美托咪定或0.9％氯化钠结束时(T1)、插管前(T2)、插管后1 min(T3)的平均动脉压、心率.结果观察组呛咳发生率,中、重度呛咳发生率均明显低于对照组[24.4％(11/45)比48.9％(22/45),11.1％(5/45)比22.2％( 10/45)],差异有统计学意义(P＜0.01).对照组T2平均动脉压低于观察组[(71.2±3.5) mm Hg(1 mm Hg=0.133 kPa)比( 84.7±4.1) mm Hg]、T3高于观察组[(96.7±6.4)mm Hg比(83.1±5.2) mm Hg],差异均有统计学意义(P＜0.05)；观察组T1、T2、T3心率低于对照组[(53.2±4.7)次/min比(70.4±6.2)次/min,(56.3±3.1) 次/min比(64.7±3.7)次/min,(59.1±4.8)次/min比(81.5±6.1)次/min],差异有统计学意义(P＜0.05).结论静脉输注0.5 μg/kg右美托咪定可以明显抑制舒芬太尼引起的呛咳反应,并且能减轻气管插管时的心血管反应.
목적 관찰정맥수주우미탁미정능부억제서분태니인기적창해반응.방법 선택로내종류절제술환자90례,안수궤수자표법분위관찰조화대조조,매조45례.관찰조마취유도전정맥수주0.5 μg/kg우미탁미정,대조조정맥수주등용량0.9％록화납,량조균10 min수주완필.급여부하제량후,량조균재3s내정맥주사0.3 μg/kg서분태니,관찰서분태니급약후1 min내창해발생정황.기록정맥수주우미탁미정혹0.9％록화납전(T0)、정맥수주우미탁미정혹0.9％록화납결속시(T1)、삽관전(T2)、삽관후1 min(T3)적평균동맥압、심솔.결과 관찰조창해발생솔,중、중도창해발생솔균명현저우대조조[24.4％(11/45)비48.9％(22/45),11.1％(5/45)비22.2％( 10/45)],차이유통계학의의(P＜0.01).대조조T2평균동맥압저우관찰조[(71.2±3.5) mm Hg(1 mm Hg=0.133 kPa)비( 84.7±4.1) mm Hg]、T3고우관찰조[(96.7±6.4)mm Hg비(83.1±5.2) mm Hg],차이균유통계학의의(P＜0.05)；관찰조T1、T2、T3심솔저우대조조[(53.2±4.7)차/min비(70.4±6.2)차/min,(56.3±3.1) 차/min비(64.7±3.7)차/min,(59.1±4.8)차/min비(81.5±6.1)차/min],차이유통계학의의(P＜0.05).결론 정맥수주0.5 μg/kg우미탁미정가이명현억제서분태니인기적창해반응,병차능감경기관삽관시적심혈관반응.
Objective To observe whether if intravenous infusion of dexmedetomidine in advance can prevent irritation and cough causing by sufentanil.Methods Ninety patients who performed excision of intracranial tumor were divided into observation group and control group by random digits table with 45 cases each.Patients in observation group were intravenously infused 0.5 μg/kg dexmedetomidine for 10 minutes before induction.Patients in control group were intravenously infused 0.9％ sodium chloride for 10 minutes before induction.All the patients were intravenously infused 0.3 μg/kg sufentanil after taking drugs of load dosage in 3 seconds,and the incidence of irritation and cough in 1 minute was observed.The mean arterial pressure and heart rate were recorded before infusing dexmedetomidine or sodium chloride(T0),at the end of infusing dexmedetomidine or sodium chloride (T1),before intubation (T2),1 minute after intubation (T3).Results The incidence of irritation and cough,moderate-severe irritation and cough in observation group [ 24.4％ ( 11/45 ),11.1％ (5/45) ] were lower than those in control group [ 48.9％ (22/45),22.2％ ( 10/45 ) ]with significant differences(P＜ 0.01 ).The mean arterial pressure in control group at T2 was lower than that in observation group [ (71.2 ± 3.5) mm Hg( 1 mm Hg =0.133 kPa) vs.(84.7 ± 4.1 ) mm Hg] with significant difference (P ＜ 0.05 ).The mean arterial pressure in control group at T3 was higher than that in observation group [(96.7 ± 6.4) mm Hg vs.(83.1 ± 5.2) mm Hg] with significant difference(P＜ 0.05).The heart rate at T1,T2,T3 in observation group was lower than that in control group [ (53.2 ± 4.7 ) beats/min vs.(70.4 ± 6.2 )beats/min,(56.3 ± 3.1 ) beats/min vs. (64.7 ± 3.7) beats/min,(59.1 ± 4.8) beats/min vs. (81.5 ± 6.1 )beats/min],and there were significant differences (P ＜0.05).Conclusions Intravenous infusion of dexmedetomidine (0.5 μg/kg) in advance can effectively prevent irritation and cough causing by sufentanil,and can enhance the stability of circulation during intubation.