中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
3期
376-378
,共3页
右美托咪定%妇科%腹腔镜手术%血流动力学%躁动
右美託咪定%婦科%腹腔鏡手術%血流動力學%躁動
우미탁미정%부과%복강경수술%혈류동역학%조동
Dexmedetomidine%Gynaecology%Laparoscopic surgery%Hemodynamics%Agitation
目的 观察术中输注右美托咪定在妇科腹腔镜全身麻醉手术后苏醒期应用的效果及安全性.方法 将80例择期行妇科腹腔镜手术患者完全随机分成右美托咪定组和对照组,每组40例.停用麻醉药后,右美托咪定组经静脉泵注右美托咪定0.4 μg/kg,10 min泵完;对照组输注等量0.9%氯化钠注射液.观察麻醉诱导前、气管插管拔管时和气管插管拔管后不同时间点平均动脉压(MAP)和心率的变化﹔患者苏醒时间、拔管时间以及拔管后10 min 视觉模拟评分(VAS)、警觉与镇静评分(OAA/S)、躁动发生率.结果与对照组比较,右美托咪定组拔管时及拔管后5 min、拔管后10 min的MAP明显降低,心率明显减慢[MAP:(89±14)mmHg(1 mmHg=0.133 kPa)比(107±15)mmHg,(75±13)mmHg比(98±16)mmHg,(78±17)mmHg比(95±15)mmHg;心率:(82±11)次/min比(113±13)次/min,(64±12)次/min比(97±11)次/min,(66±13)次/min比(108±13)次/min](均P<0.05);右美托咪定组拔管后10 min VAS评分和OAA/S评分明显低于对照组[(2.6±0.6)分比(7.9±0.9)分,(3.9±0.5)分比(4.6±0.3)分] (P<0.05);右美托咪定组躁动发生率明显低于对照组[17.5%(7/14)比65.0%(26/40),P＜0.05].结论 术中输注右美托咪定能预防妇科腹腔镜全身麻醉手术后苏醒期心血管反应,降低术后苏醒期躁动的发生率.
目的 觀察術中輸註右美託咪定在婦科腹腔鏡全身痳醉手術後囌醒期應用的效果及安全性.方法 將80例擇期行婦科腹腔鏡手術患者完全隨機分成右美託咪定組和對照組,每組40例.停用痳醉藥後,右美託咪定組經靜脈泵註右美託咪定0.4 μg/kg,10 min泵完;對照組輸註等量0.9%氯化鈉註射液.觀察痳醉誘導前、氣管插管拔管時和氣管插管拔管後不同時間點平均動脈壓(MAP)和心率的變化﹔患者囌醒時間、拔管時間以及拔管後10 min 視覺模擬評分(VAS)、警覺與鎮靜評分(OAA/S)、躁動髮生率.結果與對照組比較,右美託咪定組拔管時及拔管後5 min、拔管後10 min的MAP明顯降低,心率明顯減慢[MAP:(89±14)mmHg(1 mmHg=0.133 kPa)比(107±15)mmHg,(75±13)mmHg比(98±16)mmHg,(78±17)mmHg比(95±15)mmHg;心率:(82±11)次/min比(113±13)次/min,(64±12)次/min比(97±11)次/min,(66±13)次/min比(108±13)次/min](均P<0.05);右美託咪定組拔管後10 min VAS評分和OAA/S評分明顯低于對照組[(2.6±0.6)分比(7.9±0.9)分,(3.9±0.5)分比(4.6±0.3)分] (P<0.05);右美託咪定組躁動髮生率明顯低于對照組[17.5%(7/14)比65.0%(26/40),P＜0.05].結論 術中輸註右美託咪定能預防婦科腹腔鏡全身痳醉手術後囌醒期心血管反應,降低術後囌醒期躁動的髮生率.
목적 관찰술중수주우미탁미정재부과복강경전신마취수술후소성기응용적효과급안전성.방법 장80례택기행부과복강경수술환자완전수궤분성우미탁미정조화대조조,매조40례.정용마취약후,우미탁미정조경정맥빙주우미탁미정0.4 μg/kg,10 min빙완;대조조수주등량0.9%록화납주사액.관찰마취유도전、기관삽관발관시화기관삽관발관후불동시간점평균동맥압(MAP)화심솔적변화﹔환자소성시간、발관시간이급발관후10 min 시각모의평분(VAS)、경각여진정평분(OAA/S)、조동발생솔.결과여대조조비교,우미탁미정조발관시급발관후5 min、발관후10 min적MAP명현강저,심솔명현감만[MAP:(89±14)mmHg(1 mmHg=0.133 kPa)비(107±15)mmHg,(75±13)mmHg비(98±16)mmHg,(78±17)mmHg비(95±15)mmHg;심솔:(82±11)차/min비(113±13)차/min,(64±12)차/min비(97±11)차/min,(66±13)차/min비(108±13)차/min](균P<0.05);우미탁미정조발관후10 min VAS평분화OAA/S평분명현저우대조조[(2.6±0.6)분비(7.9±0.9)분,(3.9±0.5)분비(4.6±0.3)분] (P<0.05);우미탁미정조조동발생솔명현저우대조조[17.5%(7/14)비65.0%(26/40),P＜0.05].결론 술중수주우미탁미정능예방부과복강경전신마취수술후소성기심혈관반응,강저술후소성기조동적발생솔.
Objective To observe the effect and safety of dexmedetomidine on quality of resuscitation in patients undergoing general anesthesia after gynaecological laparoscopic surgery. Methods Eighty patients with elective gynaecological laparoscopic surgery were randomly divided into two groups:dexmedetomidine group and control group. Patients in dexmedetomidine group was given dexmedetomidine(0.4 μg/kg)intravenously,while control group was given equal volume of saline. Before tracheal extubation at different time points after tracheal extubation mean arterial pressure (MAP) and heart rate (HR), recovery time, extubation time, and 10 min after extubation visual analog scale (VAS ), alertness and sedation score (OAA / S), restlessness and agitation extent and incidence of adverse drug reactions were observed. Results MAP and HR were significantly decreased in dexmedetomidine group than in control group at the moment of extubation and 5,10 min after extubation[MAP: (89±14) mmHg vs (107±15) mmHg, (75±13) mmHg vs (98±16) mmHg, (78±17) mmHg vs (95±15) mmHg; HR: (82±11) beats/min vs (113±13) times/min, (64±12) beats/min vs (97±11) times/min, (66±13) beats/min vs (108±13) times / min] (all P<0.05 ) . The score of VAS and OAA/S were lower at 10 min after extubation in dexmedetomidine group than in control group [(2.6±0.6) scores vs (7.9±0.9) scores, (3.9±0.5) scores vs (4.6±0.3) scores] (P<0.05).Compared with control group ,the agitation incidence and level were lower in dexmedetomidine group [0 vs 12.5% (5/40)] (P<0.05). Conclusion The injection of dexmedetomidine(0.4 μg/kg)with minipump may effectively attenuate the cardiovascular reoponses on quality of resuscitation in patients undergoing general anesthesia after gynaecological laparoscopic surgery,and can reduce the postoperative incidence of agitation.
