中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
12期
116-118
,共3页
右美托咪定%神经外科%全麻%躁动%影响
右美託咪定%神經外科%全痳%躁動%影響
우미탁미정%신경외과%전마%조동%영향
Dexmedetomidine%Neurosurgery%Anesthesia%Agitation%Impact
目的：探讨右美托咪定用于神经外科全麻术患者对术后躁动发生的影响。方法：选取2011年7月-2012年8月在本院神经外科择期行全麻手术患者110例，随机分为右美托咪定组和生理盐水组，手术结束前10 min，右美托咪定组采用右美托咪定静脉泵注，生理盐水组采用等量生理盐水静脉泵注。记录两组患者唤醒时间、呼吸恢复时间和拔管时间，对两组患者拔管后躁动发生情况、躁动程度、镇痛和镇静状况进行评估。结果：两组术后唤醒时间、呼吸恢复时间和拔管时间比较差异均无统计学意义（P>0.05）。右美托咪定组麻醉拔管期躁动程度（0级、1级）和躁动发生率均低于生理盐水组，两组比较差异均有统计学意义（P<0.05）。右美托咪定组Ramsay镇静评分拔管后5 min、30 min均高于生理盐水组，两组比较差异均有统计学意义（P<0.05）。VAS疼痛评分拔管后5、30、60和120 min均显著低于生理盐水组，两组比较差异均有统计学意义（P<0.05）。结论：右美托咪定可以有效减少神经外科全麻术后躁动发生率和躁动程度，改善术后疼痛镇静效果，且不延长唤醒时间、呼吸恢复时间和拔管时间。
目的：探討右美託咪定用于神經外科全痳術患者對術後躁動髮生的影響。方法：選取2011年7月-2012年8月在本院神經外科擇期行全痳手術患者110例，隨機分為右美託咪定組和生理鹽水組，手術結束前10 min，右美託咪定組採用右美託咪定靜脈泵註，生理鹽水組採用等量生理鹽水靜脈泵註。記錄兩組患者喚醒時間、呼吸恢複時間和拔管時間，對兩組患者拔管後躁動髮生情況、躁動程度、鎮痛和鎮靜狀況進行評估。結果：兩組術後喚醒時間、呼吸恢複時間和拔管時間比較差異均無統計學意義（P>0.05）。右美託咪定組痳醉拔管期躁動程度（0級、1級）和躁動髮生率均低于生理鹽水組，兩組比較差異均有統計學意義（P<0.05）。右美託咪定組Ramsay鎮靜評分拔管後5 min、30 min均高于生理鹽水組，兩組比較差異均有統計學意義（P<0.05）。VAS疼痛評分拔管後5、30、60和120 min均顯著低于生理鹽水組，兩組比較差異均有統計學意義（P<0.05）。結論：右美託咪定可以有效減少神經外科全痳術後躁動髮生率和躁動程度，改善術後疼痛鎮靜效果，且不延長喚醒時間、呼吸恢複時間和拔管時間。
목적：탐토우미탁미정용우신경외과전마술환자대술후조동발생적영향。방법：선취2011년7월-2012년8월재본원신경외과택기행전마수술환자110례，수궤분위우미탁미정조화생리염수조，수술결속전10 min，우미탁미정조채용우미탁미정정맥빙주，생리염수조채용등량생리염수정맥빙주。기록량조환자환성시간、호흡회복시간화발관시간，대량조환자발관후조동발생정황、조동정도、진통화진정상황진행평고。결과：량조술후환성시간、호흡회복시간화발관시간비교차이균무통계학의의（P>0.05）。우미탁미정조마취발관기조동정도（0급、1급）화조동발생솔균저우생리염수조，량조비교차이균유통계학의의（P<0.05）。우미탁미정조Ramsay진정평분발관후5 min、30 min균고우생리염수조，량조비교차이균유통계학의의（P<0.05）。VAS동통평분발관후5、30、60화120 min균현저저우생리염수조，량조비교차이균유통계학의의（P<0.05）。결론：우미탁미정가이유효감소신경외과전마술후조동발생솔화조동정도，개선술후동통진정효과，차불연장환성시간、호흡회복시간화발관시간。
Objective:To investigate the impact of dexmedetomidine for patients undergoing neurosurgery general anesthesia on postoperative agitation. Method:One hundred and ten cases for elective anesthesia in the hospital neurosurgery were selected from July 2011 to August 2012. All cases were randomly divided into dexmedetomidine group and saline group. Before the end of surgery 10 min,cases in dexmedetomidine group were given dexmedetomidine intravenous infusion,and in saline group were given saline intravenous infusion. The wake-up time,breathing recovery time and extubation time of the two groups were recorded. After extubation,the occurrence of agitation,agitation degree,analgesia and sedation of the two groups were evaluated. Result:The differences of postoperative wake-up time,breathing recovery time and extubation time between the two groups were not significant(P>0.05). The agitation degree(0,1 grade)and agitation occurrence rate in anesthesia extubation in dexmedetomidine group were lower than those of the saline group,the differences were statistically significant(P<0.05). The ramsay sedation scores of dexmedetomidine group after extubation 5 min,30 min were higher than those of the saline group(P<0.05). The VAS pain scores after extubation 5 min,30 min,60 min and 120 min were significantly lower than those of the saline group,the differences all were statistically significant(P<0.05). Conclusion:Dexmedetomidine could reduce agitation occurrence rate and agitation degree of patients undergoing neurosurgery general anesthesia,and improve postoperative pain sedative effect. But it does not extend the wake-up time,breathing recovery time and extubation time.
