CAJ | 학술논문

目的：探讨不同时段应用右美托咪定对全身麻醉患者气管拔管的影响。方法选取全身麻醉患者80例，随机分为观察组和对照组，每组40例。观察组于麻醉诱导前30 min 静脉泵注右美托咪啶0．6μg /kg，对照组患者在手术结束时静脉泵注右美托咪啶0．6μg /kg，观察不同时间点2组患者血流动力学指标、躁动及不良反应等。结果拔管即刻（T1）2组患者心率（HR）、平均动脉压（MAP）水平较术前基础值（T0）均升高，但差异无统计学意义（P ＞0．05）；拔管后5 min 开始 HR 及 MAP水平逐渐下降，拔管后60 min（T6）降至与 T0相近，差异无统计学意义（P ＞0．05）。2组 T0～T6时点 HR、MAP 比较，差异无统计学意义（P ＞0．05）。2组 T0～T6时点 SpO2组间及组内比较，差异均无统计学意义（P ＞0．05）。2组苏醒时间、躁动发生率及不良反应发生率比较，差异无统计学意义（P ＞0．05）。对照组拔管时间明显长于对照组，差异有统计学意义（P ＜0．05）。结论围术期应用右美托咪啶可以有效抑制气管拔管引起的 HR 增快和血压升高，无明显呼吸抑制作用，但手术结束时应用会延长拔管时间，麻醉诱导前应用为首选。
목적：탐토불동시단응용우미탁미정대전신마취환자기관발관적영향。방법선취전신마취환자80례，수궤분위관찰조화대조조，매조40례。관찰조우마취유도전30 min 정맥빙주우미탁미정0．6μg /kg，대조조환자재수술결속시정맥빙주우미탁미정0．6μg /kg，관찰불동시간점2조환자혈류동역학지표、조동급불량반응등。결과발관즉각（T1）2조환자심솔（HR）、평균동맥압（MAP）수평교술전기출치（T0）균승고，단차이무통계학의의（P ＞0．05）；발관후5 min 개시 HR 급 MAP수평축점하강，발관후60 min（T6）강지여 T0상근，차이무통계학의의（P ＞0．05）。2조 T0～T6시점 HR、MAP 비교，차이무통계학의의（P ＞0．05）。2조 T0～T6시점 SpO2조간급조내비교，차이균무통계학의의（P ＞0．05）。2조소성시간、조동발생솔급불량반응발생솔비교，차이무통계학의의（P ＞0．05）。대조조발관시간명현장우대조조，차이유통계학의의（P ＜0．05）。결론위술기응용우미탁미정가이유효억제기관발관인기적 HR 증쾌화혈압승고，무명현호흡억제작용，단수술결속시응용회연장발관시간，마취유도전응용위수선。
Objective To explore the influence of dexmedetomidines medicated at different times on tracheal extubation in patients with general anesthesia.Methods 80 patients with general anesthesia were selected and randomly divided into observation group and control group,40 cases in each group.The observation group was intravenously pumped with 0.6 μg /kg of dexmedetomidine 3 0 minutes before anesthesia induction ,while the control group was intravenously pumped with 0.6 μg /kg of dexmedetomidine at the end of surgeries.The hemodynamic indexes,restlessness and adverse reactions were observed at different time points.Results At the time of extubation (T1), the heart disease rate (HR)and mean artery pressure (MAP)levels in both groups were higher than the baseline values before surgeries (T0)(P >0.05).In 5 minutes after extubation,HR and MAP started to decrease gradually,at 60 minutes after extubation (T6),HR and MAP decreased to val-ues near to those at T0(P >0.05).There were no significant differences of HR and MAP,SpO2, palinesthesia time,restlessness incidence and adverse reaction from T0 to T6 between two groups (P >0.05).The extubation time of the control group was significantly longer than that of the ob-servation group (P <0.05).Conclusion Perioperative application of dexmedetomidine can effec-tively inhibit HR increase and blood pressure elevation caused by tracheal extubation,without caus-ing insignificant respiratory depression effects,but application at the end of surgeries can prolong extubation time,thus,application before anesthesia induction is a better choice.