中国处方药
中國處方藥
중국처방약
CHINA PRESCRIPTION DRUG
2014年
7期
1-3
,共3页
右美托咪定%静脉全身麻醉%麻醉恢复
右美託咪定%靜脈全身痳醉%痳醉恢複
우미탁미정%정맥전신마취%마취회복
Dexmedetomidine%TIVA%Anesthesia recovery
目的：观察术前辅用右美托咪定对颈椎手术患者麻醉恢复期的影响。方法选择40例行颈椎手术的颈椎受限患者，随机分成右美托咪定组（D组，n＝20）和生理盐水组（N组，n＝20）。D组于诱导前10 min静脉泵注右美托咪啶1μg/kg，N组静脉泵注相同容量的生理盐水。行颈椎手术的颈椎受限患者术中均以瑞芬太尼（血浆浓度，4 ng/mL）和丙泊酚（血浆浓度，据术中血压调节）靶控输注维持麻醉。记录各组给药前（T1）、拔管时（T2）及拔管后10 min（T3）、30 min（T4）、60 min（T5）的动脉压（MAP）、心率（HR）、脉搏血氧饱和度（SpO2）、Ramsay镇静评分，记录患者停药拔气管时间、对口头指令反应时间；T3-T5视觉模拟评分法（VAS）疼痛评分；记录拔管后苏醒期内患者呼吸抑制、烦躁、恶心呕吐和疼痛等不良反应的情况。结果两组患者拔管时间、对口头指令反应时间比较，差异无统计学意义（P＞0.05）；D组T2～T5时点MAP、HR 明显低于N组， D组T3～T5时点VAS明显低于N组；D组Ramsay评分优于N组，且烦躁、恶心呕吐及疼痛等不良反应明显低于N组，差异均具统计学意义（P＜0.05）；D组T2时点MAP、HR 明显高于T1，N组T2时点MAP、HR 明显高于其他时点；D组及N组T5时点VAS明显高于T3～T4，差异有统计学意义（P＜0.05）。结论颈椎手术患者术前辅用右美托咪定，患者在麻醉恢复期血流动力学稳定，苏醒期呼吸、意识恢复和拔管条件不受影响，且烦躁、恶心呕吐和疼痛等不良反应减少。
目的：觀察術前輔用右美託咪定對頸椎手術患者痳醉恢複期的影響。方法選擇40例行頸椎手術的頸椎受限患者，隨機分成右美託咪定組（D組，n＝20）和生理鹽水組（N組，n＝20）。D組于誘導前10 min靜脈泵註右美託咪啶1μg/kg，N組靜脈泵註相同容量的生理鹽水。行頸椎手術的頸椎受限患者術中均以瑞芬太尼（血漿濃度，4 ng/mL）和丙泊酚（血漿濃度，據術中血壓調節）靶控輸註維持痳醉。記錄各組給藥前（T1）、拔管時（T2）及拔管後10 min（T3）、30 min（T4）、60 min（T5）的動脈壓（MAP）、心率（HR）、脈搏血氧飽和度（SpO2）、Ramsay鎮靜評分，記錄患者停藥拔氣管時間、對口頭指令反應時間；T3-T5視覺模擬評分法（VAS）疼痛評分；記錄拔管後囌醒期內患者呼吸抑製、煩躁、噁心嘔吐和疼痛等不良反應的情況。結果兩組患者拔管時間、對口頭指令反應時間比較，差異無統計學意義（P＞0.05）；D組T2～T5時點MAP、HR 明顯低于N組， D組T3～T5時點VAS明顯低于N組；D組Ramsay評分優于N組，且煩躁、噁心嘔吐及疼痛等不良反應明顯低于N組，差異均具統計學意義（P＜0.05）；D組T2時點MAP、HR 明顯高于T1，N組T2時點MAP、HR 明顯高于其他時點；D組及N組T5時點VAS明顯高于T3～T4，差異有統計學意義（P＜0.05）。結論頸椎手術患者術前輔用右美託咪定，患者在痳醉恢複期血流動力學穩定，囌醒期呼吸、意識恢複和拔管條件不受影響，且煩躁、噁心嘔吐和疼痛等不良反應減少。
목적：관찰술전보용우미탁미정대경추수술환자마취회복기적영향。방법선택40례행경추수술적경추수한환자，수궤분성우미탁미정조（D조，n＝20）화생리염수조（N조，n＝20）。D조우유도전10 min정맥빙주우미탁미정1μg/kg，N조정맥빙주상동용량적생리염수。행경추수술적경추수한환자술중균이서분태니（혈장농도，4 ng/mL）화병박분（혈장농도，거술중혈압조절）파공수주유지마취。기록각조급약전（T1）、발관시（T2）급발관후10 min（T3）、30 min（T4）、60 min（T5）적동맥압（MAP）、심솔（HR）、맥박혈양포화도（SpO2）、Ramsay진정평분，기록환자정약발기관시간、대구두지령반응시간；T3-T5시각모의평분법（VAS）동통평분；기록발관후소성기내환자호흡억제、번조、악심구토화동통등불량반응적정황。결과량조환자발관시간、대구두지령반응시간비교，차이무통계학의의（P＞0.05）；D조T2～T5시점MAP、HR 명현저우N조， D조T3～T5시점VAS명현저우N조；D조Ramsay평분우우N조，차번조、악심구토급동통등불량반응명현저우N조，차이균구통계학의의（P＜0.05）；D조T2시점MAP、HR 명현고우T1，N조T2시점MAP、HR 명현고우기타시점；D조급N조T5시점VAS명현고우T3～T4，차이유통계학의의（P＜0.05）。결론경추수술환자술전보용우미탁미정，환자재마취회복기혈류동역학은정，소성기호흡、의식회복화발관조건불수영향，차번조、악심구토화동통등불량반응감소。
Objective To investigate the influence of preoperatiive dexmedetomidine to anesthesia recovery in patients undergoing cervical operations.Methods 40 patients were randomly allocated in two groups: Dexmedetomidine group(D group,n=20), normal saline group(N group,n=20). Dexmedetomidine 1.0μg/kg was administered in patients in D group 10 minutes before induction. Meanwhile normal saline of the same volume was administered in patients in N group. Anesthesia is maintained by a target-controlled infusion(TCI) of remifentanil(plasma concentration, 4ng/ml) and propofol(plasma concentration, infusion rate adapted by blood pressure). Mean arterial pressure(MAP), heart rate(HR), saturation of pulse oximetry (SpO2) and ramsay sedation score of baseline(T1), extubation(T2),10min after extubation(T3), 30min after extubation(T4) and 60min after extubation (T5) were recorded, as well as time to extubation, time to response to verbal command. Adverse events such as respiratory depression, dysphoria, nausea and vomiting and pain are analyzed.Results No difference is shown in time to extubation and time to response to verbal command(P>0.05). Compared with N group, MAP, HR are lower at T2-T5 in D group, VAS in T3-T5 are lower in D group,Ramsay score is better in D group, adverse events are less in D group. Within D group, MAP and HR at T2 are lower than those at T1.In N group, MAP and HR at T2 are higher. VAS at T5 in both groups are higher than T3-T4(P<0.05)Conclusion Preoperative dexmedetomidine in patients undergoing cervical operations are effective and safe for it stabilizes MAP and HR, does not compromise respiration, consciousness and extubation in anesthesia recovery period, and lessen dysphoria, nausea and vomiting and pain.
