川北医学院学报
川北醫學院學報
천북의학원학보
JOURNAL OF NORTH SICHUAN MEDICAL COLLEGE
2015年
2期
187-190
,共4页
右美托咪定%瑞芬太尼%支撑喉镜
右美託咪定%瑞芬太尼%支撐喉鏡
우미탁미정%서분태니%지탱후경
Dexmedetomidine%Remifentanil%Laryngomicrosurgery
目的：：比较右美托咪定和瑞芬太尼在支撑喉镜下声带息肉摘除手术中临床应用效果。方法：将60例择期在支撑喉镜下行声带息肉切除术患者随机分为生理盐水组(NS 组)、右美组(D 组)和瑞芬组(R 组)。 D 组在麻醉诱导前泵注0．6μg/kg右美托咪定,NS组和R组泵注等量生理盐水。观察记录诱导及术中平均动脉压(mean artery pressure,MAP)、心率( heart rate,HR)、麻醉恢复情况及并发症。结果： NS组在气管插管和置入支撑喉镜后MAP和HR明显高于R组和D组( P<0．05)；D组患者围拔管期的视觉模拟评分(vision analog score,VAS)明显低于R组(P<0．05)；D组患者并发症发生率明显低于NS组和R组(P<0．05)。结论：在支撑喉镜声带息肉摘除术中,术前泵注0．6μg/kg的右美托咪定有助于术中血流动力学稳定,且无明显不良反应的发生,是一种安全有效的麻醉方法。
目的：：比較右美託咪定和瑞芬太尼在支撐喉鏡下聲帶息肉摘除手術中臨床應用效果。方法：將60例擇期在支撐喉鏡下行聲帶息肉切除術患者隨機分為生理鹽水組(NS 組)、右美組(D 組)和瑞芬組(R 組)。 D 組在痳醉誘導前泵註0．6μg/kg右美託咪定,NS組和R組泵註等量生理鹽水。觀察記錄誘導及術中平均動脈壓(mean artery pressure,MAP)、心率( heart rate,HR)、痳醉恢複情況及併髮癥。結果： NS組在氣管插管和置入支撐喉鏡後MAP和HR明顯高于R組和D組( P<0．05)；D組患者圍拔管期的視覺模擬評分(vision analog score,VAS)明顯低于R組(P<0．05)；D組患者併髮癥髮生率明顯低于NS組和R組(P<0．05)。結論：在支撐喉鏡聲帶息肉摘除術中,術前泵註0．6μg/kg的右美託咪定有助于術中血流動力學穩定,且無明顯不良反應的髮生,是一種安全有效的痳醉方法。
목적：：비교우미탁미정화서분태니재지탱후경하성대식육적제수술중림상응용효과。방법：장60례택기재지탱후경하행성대식육절제술환자수궤분위생리염수조(NS 조)、우미조(D 조)화서분조(R 조)。 D 조재마취유도전빙주0．6μg/kg우미탁미정,NS조화R조빙주등량생리염수。관찰기록유도급술중평균동맥압(mean artery pressure,MAP)、심솔( heart rate,HR)、마취회복정황급병발증。결과： NS조재기관삽관화치입지탱후경후MAP화HR명현고우R조화D조( P<0．05)；D조환자위발관기적시각모의평분(vision analog score,VAS)명현저우R조(P<0．05)；D조환자병발증발생솔명현저우NS조화R조(P<0．05)。결론：재지탱후경성대식육적제술중,술전빙주0．6μg/kg적우미탁미정유조우술중혈류동역학은정,차무명현불량반응적발생,시일충안전유효적마취방법。
Objective:To compare the effects of dexmedetomidine and remifentanil in laryngomicrosurgery. Methods:Sixty pa-tients undergoing laryngomicrosurgery were randomly divided into 3 groups:0. 9% sodium chloride injection group ( group NS) ,dexme-detomidine group ( group D) and remifentanil group ( group R) . Before anesthesia induction,group NS and group R were given 0. 9%sodium chloride injection 10 mL,and group D was given 0. 6 μg/kg dexmedetomidine 10 mL,respectively. The mean artery pressure (MAP) and heart rate (HR) were recorded at different time points. The recovery time of spontaneous breath and extubation were recor-ded after operation. The vision analog score (VAS) was recorded immediately at extubation and 5,10,20 and 30 min after tracheal ex-tubation. Results:The hemodynamics in group D and group R were more stable than that in group NS (P<0. 05). The VAS after extu-bation in group R was higher than that in group D. The incidence rate of side-effect in group D was much lower than that in group R. Conclusion:A loading dose of 0. 6 μg/kg dexmedetomidine by intravenous infusion before anesthesia can both improve the stability of hemodynamics and the recovery quality,which provides a better condition for tracheal extubation,therefore this method is deserved to be recommended in laryngomicrosurgery.
