CAJ | 학술논문

目的：观察小剂量右美托咪定或芬太尼预防气管拔管心血管反应的效果。方法选取 ASA Ⅰ~Ⅱ级全身麻醉择期手术患者60例，均在静吸复合全身麻醉下实施手术，术毕不使用阿片受体拮抗剂催醒。60例患者随机分为3组：右美托咪定组（n ＝20）于拔管前给右美托咪定0.3μg/ kg 静脉泵注（10 min），芬太尼组（n ＝20）于拔管前给芬太尼1μg/ kg 静脉注射，对照组（n ＝20）拔管前不给任何药物。观察记录用药前、拔管前、拔管后1 min、5 min 和10 min 时的心率（HR）和平均动脉压（MAP）的变化。结果右美托咪定组用药后HR 明显下降（P <0.05），右美托咪定组和芬太尼组拔管前后心血管反应变化较小（P >0.05），对照组拔管前后心血管反应变化明显（P <0.05）。术后发生躁动的患者对照组有3例，芬太尼组有1例，右美托咪定组0例。结论小剂量右美托咪定或芬太尼可有效预防围拔管期心血管反应。
목적：관찰소제량우미탁미정혹분태니예방기관발관심혈관반응적효과。방법선취 ASA Ⅰ~Ⅱ급전신마취택기수술환자60례，균재정흡복합전신마취하실시수술，술필불사용아편수체길항제최성。60례환자수궤분위3조：우미탁미정조（n ＝20）우발관전급우미탁미정0.3μg/ kg 정맥빙주（10 min），분태니조（n ＝20）우발관전급분태니1μg/ kg 정맥주사，대조조（n ＝20）발관전불급임하약물。관찰기록용약전、발관전、발관후1 min、5 min 화10 min 시적심솔（HR）화평균동맥압（MAP）적변화。결과우미탁미정조용약후HR 명현하강（P <0.05），우미탁미정조화분태니조발관전후심혈관반응변화교소（P >0.05），대조조발관전후심혈관반응변화명현（P <0.05）。술후발생조동적환자대조조유3례，분태니조유1례，우미탁미정조0례。결론소제량우미탁미정혹분태니가유효예방위발관기심혈관반응。
Objective To observe the prevention effects of cardiovascular response during tracheal extubation by a small dose of dexmedetomidine or fentanyl. Methods 60 ASA Ⅰ ~ Ⅱpatients were randomly divided into control group(n = 20),dexmedetomidine group(n = 20)and fentanyl group(n = 20). Combined general anesthesia of intra-venous and inhalation was performed in all patients without opioid receptor antagonist awakening. 0. 3 μg/ kg dexme-detomidine was pumped intravenously before extubation in dexmedetomidine group. 1 μg/ kg fentanyl was injected in-travenously before extubation in fentanyl group. No drug was given before extubation in control group. Heart rate (HR)and mean arterial pressure(MAP)were observed before medication,before extubation,1 min after extubation, 5 min after extubation and 10 min after extubation. Results HR was significantly decreased after medication in dexmedetomidine group(P < 0. 05). Cardiovascular response was small in dexmedetomidine group and fentanyl group (P > 0. 05). Cardiovascular response was large in control group(P < 0. 05). There were 3 patients with restlessness in control group and 1 case in fentanyl group. Conclusion Small - dose dexmedetomidine or fentanyl can effectively prevent cardiovascular effects during tracheal extubation.