CAJ | 학술논문

目的评价右美托咪啶对老年骨科手术患者全麻恢复期质量的影响.方法择期行骨科手术患者60例,ASA分级Ⅰ～Ⅲ级,年龄≥65岁,采用随机数字表法,将其随机分为3组(n=20):对照组(C组)、右美托咪啶0.25 μg/kg组(D1组)和右美托咪啶0.50 μg/kg组(D2组).C组、D1组和D2组分别于麻醉诱导前15 min静脉输注生理盐水、右美托咪啶0.25 μg/kg和0.50μg/kg( 15 ml),输注时间15 min.3组均采用全身麻醉,于切皮前即刻静脉注射氟比洛芬酯1 mg/kg.记录自主呼吸恢复时间、苏醒时间、拔除气管导管时间及全麻恢复期不良反应的发生情况,采用词语等级量表评分法(VRS)评估苏醒5min时疼痛程度.结果与C组比较,D1组和D2组躁动、呛咳、心血管事件发生率和VRS评分降低,镇痛有效率升高,D2组苏醒时间和拔除气管导管时间延长(P＜0.05)；与D1组比较,D2组苏醒时间和拔除气管导管时间延长(p＜0.05),VRS评分、镇痛有效率及不良反应发生率比较差异无统计学意义(P＞0.05).结论全麻诱导前静脉输注右美托咪啶0.25μg/kg可改善老年骨科手术患者全麻恢复期的质量.
목적 평개우미탁미정대노년골과수술환자전마회복기질량적영향.방법 택기행골과수술환자60례,ASA분급Ⅰ～Ⅲ급,년령≥65세,채용수궤수자표법,장기수궤분위3조(n=20):대조조(C조)、우미탁미정0.25 μg/kg조(D1조)화우미탁미정0.50 μg/kg조(D2조).C조、D1조화D2조분별우마취유도전15 min정맥수주생리염수、우미탁미정0.25 μg/kg화0.50μg/kg( 15 ml),수주시간15 min.3조균채용전신마취,우절피전즉각정맥주사불비락분지1 mg/kg.기록자주호흡회복시간、소성시간、발제기관도관시간급전마회복기불량반응적발생정황,채용사어등급량표평분법(VRS)평고소성5min시동통정도.결과 여C조비교,D1조화D2조조동、창해、심혈관사건발생솔화VRS평분강저,진통유효솔승고,D2조소성시간화발제기관도관시간연장(P＜0.05)；여D1조비교,D2조소성시간화발제기관도관시간연장(p＜0.05),VRS평분、진통유효솔급불량반응발생솔비교차이무통계학의의(P＞0.05).결론 전마유도전정맥수주우미탁미정0.25μg/kg가개선노년골과수술환자전마회복기적질량.
Objective To evaluate the effects of dexmedetomidine on the quality of emergence from general anesthesia in the elderly patients undergoing orthopedic operation.Methods Sixty ASA Ⅰ -Ⅲ patients,aged ≥65 yr,undergoing elective orthopedic operation,were randomly assigned to one of 3 groups ( n =20 each):control group (group C) ; dexmedetomidine 0.25 μg/kg group (group D1 ) and dexmnedetomidine 0.50 μg/kg group (group D2).In groups D1 and D2,15 min befone anesthesia induction,dexmedetomidine 0.25 μg/kg and 0.50 μg/kg were infused over 15 min respectively,while the equal volume of normal saline 15 ml was given instead of dexmedetomidine in group C.After anesthesia induction,tracheal intubation was performed and the patients were mechanically ventilated.General anesthesia was used in the three groups.Flurbiprofen 1 mg/kg was injected intravenously immediately before skin incision.The time for recovery of spontaneous breathing,emergence time,extubation time,and adverse reactions were recorded.Pain was assessed with verbal rating scale (VRS) at 5 min after emergence from anesthesia.Results Compared with group C,the incidence of agitation,bucking,and adverse cardiovascular events and VRS score were significantly decreased,and the rate of effective analgesia was significantly increased in groups D1 and D2,and the emergence time and extubation time were significantly prolonged in group D2(P ＜0.05).Compared with group D1,the emergence time and extubation time were significantly prolonged in group D2(P＜0.05).There was no significant difference in VRS score,the rate of effective analgesia and the incidence of adverse renctions between groups D1 and D2(P＞0.05).Conclusion Ⅳ infusion of dexmedetomidine 0.25 μg/kg before induction of general anesthesia can effectively improve the quality of emergence from general anesthesia in the elderly patients undergoing orthopedic operation.