CAJ | 학술논문

目的：比较单剂量右美托咪定与芬太尼用于成人全身麻醉后苏醒期躁动的治疗效果。方法择期气管插管全麻下手术并发生术后躁动的患者60例，年龄38～59岁，随机分为两组：右美托咪定组（D 组）和芬太尼组（F 组），每组30例。D 组单次静注右美托咪定0.5μg／kg，F 组单次静注芬太尼1μg／kg。若经上述治疗后患者仍有躁动表现，则给予间断静脉推注丙泊酚每次1.0 mg／kg，直至患者 Riker 躁动评分达到轻度以下。结果给予单剂量的右美托咪定处理后，D 组有29例患者达到平静状态，呼之能应，无刺激后即入睡，另有1例仍有轻度躁动；经单剂量的芬太尼处理后，F 组仍有4例患者躁动严重，另有4例为中度躁动，9例为轻度躁动。与 F 组比较，D 组经首次处理后，轻度、中度、重度躁动例数明显减少（P＜0.05）。从用药至平息躁动的时间 D 组为（11±3）min，明显短于 F 组的（27±9）min （P＜0.05）。D 组丙泊酚总量为（50±0）mg，明显少于 F 组的（270±40）mg （P＜0.05）。治疗期间，F 组有9例（30％）轻度呼吸抑制，D 组有21例（70％）发生心动过缓（P＜0.05）。结论右美托咪定0.5μg／kg 对成人全麻后躁动的治疗效果满意，并发症轻微，优于芬太尼。
목적：비교단제량우미탁미정여분태니용우성인전신마취후소성기조동적치료효과。방법택기기관삽관전마하수술병발생술후조동적환자60례，년령38～59세，수궤분위량조：우미탁미정조（D 조）화분태니조（F 조），매조30례。D 조단차정주우미탁미정0.5μg／kg，F 조단차정주분태니1μg／kg。약경상술치료후환자잉유조동표현，칙급여간단정맥추주병박분매차1.0 mg／kg，직지환자 Riker 조동평분체도경도이하。결과급여단제량적우미탁미정처리후，D 조유29례환자체도평정상태，호지능응，무자격후즉입수，령유1례잉유경도조동；경단제량적분태니처리후，F 조잉유4례환자조동엄중，령유4례위중도조동，9례위경도조동。여 F 조비교，D 조경수차처리후，경도、중도、중도조동례수명현감소（P＜0.05）。종용약지평식조동적시간 D 조위（11±3）min，명현단우 F 조적（27±9）min （P＜0.05）。D 조병박분총량위（50±0）mg，명현소우 F 조적（270±40）mg （P＜0.05）。치료기간，F 조유9례（30％）경도호흡억제，D 조유21례（70％）발생심동과완（P＜0.05）。결론우미탁미정0.5μg／kg 대성인전마후조동적치료효과만의，병발증경미，우우분태니。
Objective To investigate the effects of single dose of dexmedetomidine and fentynyl on treatment of emergence agitation in adult patients after general anesthesia.Methods Sixty patients suffering from emergence agitation after general anesthesia were divided into two groups randomly(n=30 each):dexmedetomidine group (group D)and fentaynl group (group F).Patients in group D received dexmedetomidine at a dose of 0.5μg/kg,and those in group F received fentanyl at a dose of 1μg/kg respectively.If patients still agitate after above treatment,intermission infusion of propofol at bolus of 1.0 mg/kg was used for further treatment till patients attain peaceful state.Results Twen-ty-nine paients in group D had no agitation,only one patient had mild agitation after administration of dexmedetomidine,while four patients had severe agitation,four patients had moderate agitation and 9 patients had mild agitation after administration of fentanyl(P<0.05);the time from first treatment to no agitation in group D was (11±3)min,shorter than that in group F (27±9)min (P<0.05);the dose of propofol used in group D was (50±0)mg,less than accumulative doses of propofol in group F (270±40)mg (P<0.05);21 (70%)patients in group D had radycardia and 9 (30%)patients in group F had respiratory depression(P<0.05).Conclusion Intravenous dexmedetomidine at a dose of 0.5 μg/kg attainted was effective in treating emergence agitation in adult patients after general anes-thesia as compared with fentanyl.