CAJ | 학술논문

目的：研究右美托咪定减少全麻下老年女性患者妇科手术术后谵妄的效果。方法选择在全麻下行妇科手术的老年女性患者60例,随机分为右美托咪定组(A组),生理盐水组(B组),各30例。两组采用相同的麻醉诱导和麻醉维持方式,术后均采用一次性镇痛泵静脉镇痛。 A组给予右美托咪定(浓度为4μg/ml)3μg/(kg·h)持续10min,然后以右美托咪定(浓度为4μg/ml)0．3μg/(kg·h)维持至手术结束；B组给予同等剂量的生理盐水。分别记录麻醉持续时间,停药后自主呼吸恢复时间(min)、拔管时间(min)、拔管时镇静-躁动评分,拔管后15min舒适度评分,以及术后48小时患者的谵妄评定方法中文修订版评分情况。结果两组患者术中麻醉持续时间差异无统计学意义(P>0．05),停药后自主呼吸恢复时间、拔管时间、拔管时镇静-躁动评分、拔管后15min舒适度评分、术后48小时CAM． CR评分情况均差异有统计学意义(P<0．05)。结论术中静脉持续微量泵入右美托咪定能够有效的减少老年女性患者妇科手术术后谵妄的发生,并且减低全麻苏醒期躁动发生率,提高患者的满意度。
목적：연구우미탁미정감소전마하노년녀성환자부과수술술후섬망적효과。방법선택재전마하행부과수술적노년녀성환자60례,수궤분위우미탁미정조(A조),생리염수조(B조),각30례。량조채용상동적마취유도화마취유지방식,술후균채용일차성진통빙정맥진통。 A조급여우미탁미정(농도위4μg/ml)3μg/(kg·h)지속10min,연후이우미탁미정(농도위4μg/ml)0．3μg/(kg·h)유지지수술결속；B조급여동등제량적생리염수。분별기록마취지속시간,정약후자주호흡회복시간(min)、발관시간(min)、발관시진정-조동평분,발관후15min서괄도평분,이급술후48소시환자적섬망평정방법중문수정판평분정황。결과량조환자술중마취지속시간차이무통계학의의(P>0．05),정약후자주호흡회복시간、발관시간、발관시진정-조동평분、발관후15min서괄도평분、술후48소시CAM． CR평분정황균차이유통계학의의(P<0．05)。결론술중정맥지속미량빙입우미탁미정능구유효적감소노년녀성환자부과수술술후섬망적발생,병차감저전마소성기조동발생솔,제고환자적만의도。
Objective To investigate the results of dexmedetomidine improvement of postoperative delirium following gynaecologic surgery in elderly female patients by general anesthesia. Methods 60 cases of elderly female patients with gynaeco-logic surgery were performed general anesthesia. All cases were randomized into normal dexmedetomidine group ( group A, n=30) and saline group (group B, n=30). The saline and Dexmedetomidine (4μg/ml) was infused with 3μg/(kg·h) for 10 min, then persistently infused with 0. 3μg/( kg·h) to the end of operation in group A and group B, respectively. The following varia-bles were analyzed, including the duration of anesthesia, the recovery time of the autonomous respiration( >10bpm), the extuba-tion time, the richmond agitation-sedation scale(RASS) in extubation, the comfort score after extubation 15min and the CAM Chi-nese reversion after 48 hours of operation. Results There was no significant difference in the duration of anesthesia. The recovery time of the autonomous respiration, the extubation time, the RASS in extubation, the comfort score after extubation 15min were ob-viously different between two groups(all P<0. 05). TThe incidence of postoperative Delirium was significantly lower in group A than one in group B. Conclusion The dexmedetomidine can effectively decrease the incidence of postoperative Delirium following gynaecologic surgery for elderly female patients, the can effectively decrease the agitation rate during recovery period from general anesthesia and a rise in patient satisfaction.