CAJ | 학술논문

目的：观察右美托咪定在支气管介入手术全麻喉罩中的麻醉效果。方法选择支气管介入手术全麻喉罩患者52例，随机分为右美托咪定组和对照组，每组26例。右美托咪定组于麻醉诱导前10 min，用微量泵静脉给予右美托咪定负荷量1.0μg/kg ，静脉泵入10 min后开始麻醉诱导。之后输注速度设定为0.4~0.6μg/kg/h，直至手术结束。对照组用等量生理盐水代替右美托咪定静脉泵入。记录患者入室时的基础值（T0）、麻醉诱导插入喉罩前（T1）、插入喉罩后1 min（T2）、手术操作15 min（T3）、手术结束时停用所有麻醉用药（T4）和患者苏醒喉罩拔出时（T5）的心率（HR）、动脉血压、气道压、维持呼气末CO2（ETCO2）及血氧饱和度（ SpO2）。记录喉罩拔出前后的Ramsay镇静评分和体动呛咳反应。结果两组患者HR和动脉血压在麻醉诱导后插入喉罩前均下降。对照组患者HR和动脉血压在T2、T3、T4、T5时都明显升高，而右美托咪定组无明显变化，两组比较有统计学意义（ P<0.05）。术后右美托咪定组Ramsay镇静评分明显优于对照组，体动呛咳反应少于对照组，两组比较差异有统计学意义（ P<0.05）。结论右美托咪定在支气管介入手术中全麻喉罩可以提供更稳定的麻醉效果，维持血流动力学的平稳，并能减少不良反应且不影响呼吸及苏醒质量。
목적：관찰우미탁미정재지기관개입수술전마후조중적마취효과。방법선택지기관개입수술전마후조환자52례，수궤분위우미탁미정조화대조조，매조26례。우미탁미정조우마취유도전10 min，용미량빙정맥급여우미탁미정부하량1.0μg/kg ，정맥빙입10 min후개시마취유도。지후수주속도설정위0.4~0.6μg/kg/h，직지수술결속。대조조용등량생리염수대체우미탁미정정맥빙입。기록환자입실시적기출치（T0）、마취유도삽입후조전（T1）、삽입후조후1 min（T2）、수술조작15 min（T3）、수술결속시정용소유마취용약（T4）화환자소성후조발출시（T5）적심솔（HR）、동맥혈압、기도압、유지호기말CO2（ETCO2）급혈양포화도（ SpO2）。기록후조발출전후적Ramsay진정평분화체동창해반응。결과량조환자HR화동맥혈압재마취유도후삽입후조전균하강。대조조환자HR화동맥혈압재T2、T3、T4、T5시도명현승고，이우미탁미정조무명현변화，량조비교유통계학의의（ P<0.05）。술후우미탁미정조Ramsay진정평분명현우우대조조，체동창해반응소우대조조，량조비교차이유통계학의의（ P<0.05）。결론우미탁미정재지기관개입수술중전마후조가이제공경은정적마취효과，유지혈류동역학적평은，병능감소불량반응차불영향호흡급소성질량。
Objective Toobservetheeffectofdexmedetomidineinlaryngealmaskalrwayundergeneralanesthe-sialnbronchialinterventionsurgery.Methods 52patientsunderwentlaryngealmaskalrwayundergeneralanesthesia in bronchial intervention surgery were randomly divided into dexmedetomidine group and control group with 26 patients in each group. 1. 0μg/kg dexmedetomidine was given intravenously with micro-pump 10 min before anesthesia in-duction. Drug administration rate was 0. 4~0. 6 μg/kg/h after induction until the end of surgery. Normal saline was given instead of dexmedetomidine in the control group. Heart rate( HR),arterial blood pressure,alrway pressure, ETCO2 and oxygen saturation( SpO2 )were recorded at the time of entering operation room( T0 ),before laryngeal mask alrway(T1),1 min after laryngeal mask alrway(T2),15 min in surgery(T3),stopping all drugs at the end of surgery( T4 ),and awakening when pulling out laryngeal mask( T5 ). Ramsay sedation score,body movement and coughreflexwererecordedbeforeandafterremovinglaryngealmask.Results HRandarterialbloodpressurede-creased after anesthesia induction and before insertion of laryngeal mask in both groups. HR and arterial blood pres-sure increased in T2,T3,T4 and T5 in the control group(P<0. 05). There was no significant difference between HR and arterial blood pressure in dexmedetomidine group(P>0. 05). Ramsay score in dexmedetomidine group was superior to that in the control group;Body movement and cough reflex were less in dexmedetomidine group( P<0. 05).Conclusion Dexmedetomidineinlaryngealmaskalrwayundergeneralanesthesialnbronchialinterventionsur-gery can provide a more stable anesthetic effect,malntaln stable hemodynamics and reduce adverse reactions without affecting breath and analepsia.