齐齐哈尔医学院学报
齊齊哈爾醫學院學報
제제합이의학원학보
JOURNAL OF QIQIHAR MEDICAL COLLEGE
2015年
13期
1881-1883
,共3页
靶控输注%瑞芬太尼%右美托咪定%气管拔管
靶控輸註%瑞芬太尼%右美託咪定%氣管拔管
파공수주%서분태니%우미탁미정%기관발관
Target controlled infusion%Remifentanil%Dexmedetomidine%Tracheal extubation
目的：观察小剂量瑞芬太尼靶控输注（ TCI）联合右美托咪啶用于抑制气管拔管期呛咳反应的临床效果。方法120例ASAⅠ～Ⅱ级，拟择期全麻下行鼻内窥镜手术的患者，随机分为两组，右旋美托咪啶组（D组）和对照组（C组），每组60例。手术结束前10 min， D组输注右美托咪啶负荷剂量0．5μg／kg，C组给予等容量生理盐水，同时将瑞芬太尼TCI效应室靶浓度调为1 ng／ml，直至气管导管拔出才停止输注。记录麻醉诱导前、输注Dex或生理盐水前和后、睁眼时、拔管时、拔管后10 min的MAP、HR、RR以及呛咳评分。结果气管拔管期，D组的呛咳反应发生率明显低于C组，C组MAP、HR高于D组，两组RR无统计学差异。 D组拔管时间稍长于C组，但无统计学差异。结论小剂量瑞芬太尼靶控输注（ TCI ）联合右美托咪啶能显著抑制气管拔管期呛咳反应，血流动力学更平稳，不延长苏醒时间。
目的：觀察小劑量瑞芬太尼靶控輸註（ TCI）聯閤右美託咪啶用于抑製氣管拔管期嗆咳反應的臨床效果。方法120例ASAⅠ～Ⅱ級，擬擇期全痳下行鼻內窺鏡手術的患者，隨機分為兩組，右鏇美託咪啶組（D組）和對照組（C組），每組60例。手術結束前10 min， D組輸註右美託咪啶負荷劑量0．5μg／kg，C組給予等容量生理鹽水，同時將瑞芬太尼TCI效應室靶濃度調為1 ng／ml，直至氣管導管拔齣纔停止輸註。記錄痳醉誘導前、輸註Dex或生理鹽水前和後、睜眼時、拔管時、拔管後10 min的MAP、HR、RR以及嗆咳評分。結果氣管拔管期，D組的嗆咳反應髮生率明顯低于C組，C組MAP、HR高于D組，兩組RR無統計學差異。 D組拔管時間稍長于C組，但無統計學差異。結論小劑量瑞芬太尼靶控輸註（ TCI ）聯閤右美託咪啶能顯著抑製氣管拔管期嗆咳反應，血流動力學更平穩，不延長囌醒時間。
목적：관찰소제량서분태니파공수주（ TCI）연합우미탁미정용우억제기관발관기창해반응적림상효과。방법120례ASAⅠ～Ⅱ급，의택기전마하행비내규경수술적환자，수궤분위량조，우선미탁미정조（D조）화대조조（C조），매조60례。수술결속전10 min， D조수주우미탁미정부하제량0．5μg／kg，C조급여등용량생리염수，동시장서분태니TCI효응실파농도조위1 ng／ml，직지기관도관발출재정지수주。기록마취유도전、수주Dex혹생리염수전화후、정안시、발관시、발관후10 min적MAP、HR、RR이급창해평분。결과기관발관기，D조적창해반응발생솔명현저우C조，C조MAP、HR고우D조，량조RR무통계학차이。 D조발관시간초장우C조，단무통계학차이。결론소제량서분태니파공수주（ TCI ）연합우미탁미정능현저억제기관발관기창해반응，혈류동역학경평은，불연장소성시간。
Objective To investigate the effect of a low -dose remifentanil combined with dexmedetomidine infusion on cough suppression during tracheal extubation .Methods American Society of Anesthesiologists physical status I -II adults undergoing elective endoscopic sinus surgery under sevoflurane anesthesia were recruited and randomly allocated to receive either dexmedetomidine 0.5μg/kg iv ( Group D,n=60) or saline (Group C,n=60), each combined with a low -dose remifentanil infusion ten minutes before the end of surgery.Coughing was assessed using a four -point scale.The respiratory rate (RR), heart rate (HR), and mean arterial pressure were also recorded .Results The incidence of coughing was lower in Group D than in Group C (P <0.05).Mean arterial pressure and HR were elevated in Group C during tracheal extubation compared to baseline values in Group D .There was no difference in RR between the two groups throughout the study.A small delay in extubation was observed in Group D ( P >0.05).Conclusions Compared with an infusion of low -dose remifentanil alone, the addition of a single dose (0.5μg/kg) of dexmedetomidine was effective in attenuating coughing during tracheal extubation and with little hemodynamic changes and did not exacerbate awake time after endoscopic sinus surgery .
