国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2013年
7期
584-587
,共4页
右旋美托咪定%食管癌手术%全身麻醉苏醒期%副作用
右鏇美託咪定%食管癌手術%全身痳醉囌醒期%副作用
우선미탁미정%식관암수술%전신마취소성기%부작용
Dexmedetomidine%Esophageal surgery%General anesthesia recovery period%Side effect
目的 观察持续泵注不同剂量右旋美托咪定(dexmedetomidine,DEX)对缓解食管癌手术患者麻醉苏醒期副作用的影响. 方法 60例食管癌手术患者按随机数字表法分为DEX 1组(D1组)、DEX 2组(D2组)和对照组(C组),每组20例.麻醉诱导前10 min D组泵注DEX 0.8 μg/kg,然后D1组、D2组分别以0.4μg·kg-1 ·h-1和0.2μg·kg-1·h-1持续泵注至术毕,同期C组给予等量生理盐水.记录患者入麻醉后苏醒室时(T1)、拔管即时(T2)以及拔管后5 min(T3)的平均动脉压(mean artery pressure,MAP)、心率(heart rate,HR)和苏醒时间.血压＞180 mm Hg/100 mm Hg(1 mm Hg=0.133 kPa)给予盐酸乌拉地尔注射液25 mg,HR＞110次/min给予盐酸艾司洛尔注射液20 mg,同时观察躁动评分和Ramsay评分. 结果 苏醒时间D1组[(30.3±4.7) min]明显长于D2组和C组(P＜0.05).D1组T2时MAP[(88±8) mm Hg]和HR[(79±5)次/min]以及D2组T2时MAP[(93±8) mm Hg]和HR[(81±6)次/min]均显著升高(P＜0.05),T3时MAP和HR回复至入麻醉后苏醒室时水平.C组T2时MAP[(117±12) mm Hg]和HR[(107±8)次/min]以及T3时MAP[(108±9) mm Hg]和HR[(118±11)次/min]也显著高于入麻醉后苏醒室时(P＜0.05).C组乌拉地尔和艾司洛尔的使用率显著多于D组(P＜0.05),D1组和D2组的躁动评分分别是(1.2±0.8)和(1.4±0.6),显著低于C组(P＜0.05)；D1组和D2组的镇静评分分别是(4.5±1.2)和(4.0±0.7),显著高于C组(P＜0.05). 结论 麻醉诱导前10 min泵注DEX 0.8 μg/kg,术中持续泵注0.2 μg·kg-1·h-1 DEX能缓解食管癌手术患者苏醒期副作用,既不影响苏醒又能很好地抑制术后躁动.
目的 觀察持續泵註不同劑量右鏇美託咪定(dexmedetomidine,DEX)對緩解食管癌手術患者痳醉囌醒期副作用的影響. 方法 60例食管癌手術患者按隨機數字錶法分為DEX 1組(D1組)、DEX 2組(D2組)和對照組(C組),每組20例.痳醉誘導前10 min D組泵註DEX 0.8 μg/kg,然後D1組、D2組分彆以0.4μg·kg-1 ·h-1和0.2μg·kg-1·h-1持續泵註至術畢,同期C組給予等量生理鹽水.記錄患者入痳醉後囌醒室時(T1)、拔管即時(T2)以及拔管後5 min(T3)的平均動脈壓(mean artery pressure,MAP)、心率(heart rate,HR)和囌醒時間.血壓＞180 mm Hg/100 mm Hg(1 mm Hg=0.133 kPa)給予鹽痠烏拉地爾註射液25 mg,HR＞110次/min給予鹽痠艾司洛爾註射液20 mg,同時觀察躁動評分和Ramsay評分. 結果 囌醒時間D1組[(30.3±4.7) min]明顯長于D2組和C組(P＜0.05).D1組T2時MAP[(88±8) mm Hg]和HR[(79±5)次/min]以及D2組T2時MAP[(93±8) mm Hg]和HR[(81±6)次/min]均顯著升高(P＜0.05),T3時MAP和HR迴複至入痳醉後囌醒室時水平.C組T2時MAP[(117±12) mm Hg]和HR[(107±8)次/min]以及T3時MAP[(108±9) mm Hg]和HR[(118±11)次/min]也顯著高于入痳醉後囌醒室時(P＜0.05).C組烏拉地爾和艾司洛爾的使用率顯著多于D組(P＜0.05),D1組和D2組的躁動評分分彆是(1.2±0.8)和(1.4±0.6),顯著低于C組(P＜0.05)；D1組和D2組的鎮靜評分分彆是(4.5±1.2)和(4.0±0.7),顯著高于C組(P＜0.05). 結論 痳醉誘導前10 min泵註DEX 0.8 μg/kg,術中持續泵註0.2 μg·kg-1·h-1 DEX能緩解食管癌手術患者囌醒期副作用,既不影響囌醒又能很好地抑製術後躁動.
목적 관찰지속빙주불동제량우선미탁미정(dexmedetomidine,DEX)대완해식관암수술환자마취소성기부작용적영향. 방법 60례식관암수술환자안수궤수자표법분위DEX 1조(D1조)、DEX 2조(D2조)화대조조(C조),매조20례.마취유도전10 min D조빙주DEX 0.8 μg/kg,연후D1조、D2조분별이0.4μg·kg-1 ·h-1화0.2μg·kg-1·h-1지속빙주지술필,동기C조급여등량생리염수.기록환자입마취후소성실시(T1)、발관즉시(T2)이급발관후5 min(T3)적평균동맥압(mean artery pressure,MAP)、심솔(heart rate,HR)화소성시간.혈압＞180 mm Hg/100 mm Hg(1 mm Hg=0.133 kPa)급여염산오랍지이주사액25 mg,HR＞110차/min급여염산애사락이주사액20 mg,동시관찰조동평분화Ramsay평분. 결과 소성시간D1조[(30.3±4.7) min]명현장우D2조화C조(P＜0.05).D1조T2시MAP[(88±8) mm Hg]화HR[(79±5)차/min]이급D2조T2시MAP[(93±8) mm Hg]화HR[(81±6)차/min]균현저승고(P＜0.05),T3시MAP화HR회복지입마취후소성실시수평.C조T2시MAP[(117±12) mm Hg]화HR[(107±8)차/min]이급T3시MAP[(108±9) mm Hg]화HR[(118±11)차/min]야현저고우입마취후소성실시(P＜0.05).C조오랍지이화애사락이적사용솔현저다우D조(P＜0.05),D1조화D2조적조동평분분별시(1.2±0.8)화(1.4±0.6),현저저우C조(P＜0.05)；D1조화D2조적진정평분분별시(4.5±1.2)화(4.0±0.7),현저고우C조(P＜0.05). 결론 마취유도전10 min빙주DEX 0.8 μg/kg,술중지속빙주0.2 μg·kg-1·h-1 DEX능완해식관암수술환자소성기부작용,기불영향소성우능흔호지억제술후조동.
Objective To observe alleviation of side effect in post-anesthesia recovery patients with esophageal surgery by continuous infusion of different doses of dexmedetomidine (DEX).Methods A total of 60 patients with esophageal cancer surgery were randomly divided into three groups,20 patients in each group.Before induction of anesthesia,0.8 μg/kg of DEX were pumped into patients of group D,then 0.4 μg·kg-1·h-1 of DEX were continuously infused till the end of surgery in group D1.0.2 μg·kg-1·h-1 of DEX were continuously infused till the end of surgery in group D2.patients of group C were continuously infused saline as controls.Mean artery pressure(MAP) and heart rate(HR) were recorded once in the recovery room(T1),extubation time(T2) and five min after extubation(T3).The recovery time,agitation score and Ramsay score were recorded,the Urapidil injection 25 mg or the esmolol injection 20 mg were given while blood pressure was＞180 mm Hg/100 mm Hg(1 mm Hg=0.133 kPa) or HR was＞110 bpm.Results the recovery time of group D1(30.3±4.7) min was significantly higher than group D2 and group C(P＜0.05),group D2 and group C had no difference (P＞0.05).MAP and HR of group D1 and group D2 at extubation were significantly higher than the recovery room.MAP and HR in group C at T2 (117±12) mm Hg,(107±8) bpm and T3 (108±9) mm Hg,(118±11) bpm were significantly increased compared with the recovery room (P＜0.05).MAP and HR in group D1(88±8) mm Hg,(79±5) bpm and group D2(93±8) mm Hg,(81 ±6) bpm at T2 were significantly descreased compared with group C.the dosage of urapidil and esmolol in group C were significantly increased compared with group D.agitation score of group C (2.9±0.4) significantly higher than group D1 (1.2±0.8) and group D2(1.4±0.6) (P＜0.05).the sedation score of group C (1.1 ±0.5) significantly lower than group D1 (4.5±1.2) and group D2(4.0±0.7)(P＜0.05).Conclusions DEX was able to alleviate the side effect of patients in post-anesthesia recovery.0.2 μg·kg-1 ·h-1 of DEX will not affect the recovery time and can inhibit postoperative agitation,and reduce the adverse effects in the anesthesia recovery period.
