中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
19期
1-3
,共3页
王子申%王福军%孔珉珉%孙小珊%李俊
王子申%王福軍%孔珉珉%孫小珊%李俊
왕자신%왕복군%공민민%손소산%리준
右美托咪啶%全麻苏醒期%气管拔管%镇静%躁动
右美託咪啶%全痳囌醒期%氣管拔管%鎮靜%躁動
우미탁미정%전마소성기%기관발관%진정%조동
Dexmedetomidine%Recovery period of general anesthesia%Tracheal extubation%Calm%Agitation
目的：探讨手术结束前右美托咪啶的使用对依托咪酯-瑞芬太尼全麻后患者躁动的影响。方法100例择期全麻下妇科腹腔镜手术的患者, ASA I~II级,随机分为右美托咪啶组(D组,50例)和对照组(C组,50例),常规麻醉诱导：气管插管后控制呼吸。术中麻醉维持：依托咪酯靶控效应室(Arden Model)浓度为0.3μg/ml,瑞芬太尼0.20~0.4μg/(kg·min)持续输注,维库溴铵维持肌松。手术结束前30 min接静脉镇痛泵。两组患者均于手术结束前10 min停止麻醉药物的输入,用静脉推注泵分别静脉推注生理盐水(C组)和右美托咪啶0.5μg/kg,推注时间均为10 min。比较两组的苏醒、拔管时间、拔管期间患者躁动的情况,观察HR、SBP、DBP、RR的变化。结果镇静和躁动情况与T0比较, C组T2、T4、T5时镇静评分均降低(P<0.05)；D组T2、T4~T6时的镇静评分均显著升高(P<0.01),且高于C组(P<0.01)。D组躁动程度评分均显著低于C组(P<0.01)。结论手术结束前静脉给予右美托咪啶0.5μg/kg,能显著减少依托咪酯静脉麻醉后所致的躁动反应,使血流动力学更趋稳定,且不会使患者苏醒期延长。
目的：探討手術結束前右美託咪啶的使用對依託咪酯-瑞芬太尼全痳後患者躁動的影響。方法100例擇期全痳下婦科腹腔鏡手術的患者, ASA I~II級,隨機分為右美託咪啶組(D組,50例)和對照組(C組,50例),常規痳醉誘導：氣管插管後控製呼吸。術中痳醉維持：依託咪酯靶控效應室(Arden Model)濃度為0.3μg/ml,瑞芬太尼0.20~0.4μg/(kg·min)持續輸註,維庫溴銨維持肌鬆。手術結束前30 min接靜脈鎮痛泵。兩組患者均于手術結束前10 min停止痳醉藥物的輸入,用靜脈推註泵分彆靜脈推註生理鹽水(C組)和右美託咪啶0.5μg/kg,推註時間均為10 min。比較兩組的囌醒、拔管時間、拔管期間患者躁動的情況,觀察HR、SBP、DBP、RR的變化。結果鎮靜和躁動情況與T0比較, C組T2、T4、T5時鎮靜評分均降低(P<0.05)；D組T2、T4~T6時的鎮靜評分均顯著升高(P<0.01),且高于C組(P<0.01)。D組躁動程度評分均顯著低于C組(P<0.01)。結論手術結束前靜脈給予右美託咪啶0.5μg/kg,能顯著減少依託咪酯靜脈痳醉後所緻的躁動反應,使血流動力學更趨穩定,且不會使患者囌醒期延長。
목적：탐토수술결속전우미탁미정적사용대의탁미지-서분태니전마후환자조동적영향。방법100례택기전마하부과복강경수술적환자, ASA I~II급,수궤분위우미탁미정조(D조,50례)화대조조(C조,50례),상규마취유도：기관삽관후공제호흡。술중마취유지：의탁미지파공효응실(Arden Model)농도위0.3μg/ml,서분태니0.20~0.4μg/(kg·min)지속수주,유고추안유지기송。수술결속전30 min접정맥진통빙。량조환자균우수술결속전10 min정지마취약물적수입,용정맥추주빙분별정맥추주생리염수(C조)화우미탁미정0.5μg/kg,추주시간균위10 min。비교량조적소성、발관시간、발관기간환자조동적정황,관찰HR、SBP、DBP、RR적변화。결과진정화조동정황여T0비교, C조T2、T4、T5시진정평분균강저(P<0.05)；D조T2、T4~T6시적진정평분균현저승고(P<0.01),차고우C조(P<0.01)。D조조동정도평분균현저저우C조(P<0.01)。결론수술결속전정맥급여우미탁미정0.5μg/kg,능현저감소의탁미지정맥마취후소치적조동반응,사혈류동역학경추은정,차불회사환자소성기연장。
Objective To investigate the effect of dexmedetomidine on agitation after etomidate-remifentanil anesthesiabefore end of surgery.MethodsChose 100 patients who under general anesthesia laparoscopic operation, ASA I~II, randomly divided them into dexmedetomidine group(group D, 50 cases) and control group(group C, 50 cases), routine anesthesia induction, after tracheal intubation, breath control, maintenance of anesthesia: etomidate target controlled effect compartment (Arden Model) concentration of 0.3μg/ml, remifentanil 0.20~0.4μg/(kg·min) continuous infusion, vecuronium to maintain muscle relaxation. Operation before the end of 30 min after intravenous analgesia pump. Two groups of patients in operation before the end of the 10min stop drug input, using intravenous injection pump intravenous injection of physiological saline (group C) and dexmedetomidine 0.5μ g/kg, injection time of 10min. Compared with two groups of awakening, extubation time, extubation agitation of patients with HR, to observe the change of situation; SBP, DBP, RR. Analysis of data using SPSS 13 statistical softwar.ResultsSedation and agitation conditions compared with T0 group, Ramsay score decreased at T2, T4, T5 in group C(P<0.05); group D, T2, T4~T6 Ramsay score increased significantly (P<0.01), and higher than that of group C (P<0.01). Group D agitation score was significantly lower than group C (P<0.01).ConclusionIntravenous dexmedetomidine 0.5μg/kg before end of surgery can significantly reduce agitation etomidate intravenous anesthesia recovery period, stable hemodynamics without extending extubation time.
