西南国防医药
西南國防醫藥
서남국방의약
MEDICAL JOURNAL OF NATIONAL DEFENDING FORCES IN SOUTHWEST CHINA
2015年
6期
584-586,587
,共4页
右美托咪定%脑电双频指数%复苏%拔管期
右美託咪定%腦電雙頻指數%複囌%拔管期
우미탁미정%뇌전쌍빈지수%복소%발관기
dexmedetomidine%BIS index%recovery%extubation period
研究全凭静脉麻醉诱导前预注小剂量右美托咪定对腹腔镜胆囊切除患者拔管期脑电双频(BIS)指数和复苏情况的影响。64例行择期腹腔镜下胆囊切除手术患者随机分为右美托咪定组(D组)和对照组(C组)，各32例。全麻诱导前，D组微量泵缓慢静注右美托咪定0.5μg/kg，C组给予等量生理盐水，10 min注射完毕。所有患者采用丙泊酚-瑞芬太尼靶控输注(TCI)全凭静脉麻醉，术中常规生命体征监测。记录患者术前(T0)、停TCI即刻(T1)、停TCI后5 min(T2)、自主呼吸恢复(T3)、神志恢复(T4)、拔管(T5)及拔管后5 min(T6)的BIS指数。分别记录停TCI至BIS达65、75、85、95及呼吸恢复、神志恢复、拔管的时间。比较拔管即刻至拔管后20 min患者不良反应发生情况。(1)D组T2~T3时BIS值低于C组(<0.05)，T4~T6时与C组无统计学差异(>0.05)。(2)D组BIS值达到65、75的时程明显长于C组(<0.05)，但D组BIS值达到85和95，以及呼吸恢复、神志恢复、拔管时间与C组无统计学差异(>0.05)。(3)拔管期，D组呛咳、躁动、恶心、呕吐、循环波动发生例数明显少于C组(<0.05)。麻醉诱导前预注小剂量右美托咪定，不影响腹腔镜胆囊切除患者术毕的清醒程度和复苏时间，且有利于减少拔管期不良反应。
研究全憑靜脈痳醉誘導前預註小劑量右美託咪定對腹腔鏡膽囊切除患者拔管期腦電雙頻(BIS)指數和複囌情況的影響。64例行擇期腹腔鏡下膽囊切除手術患者隨機分為右美託咪定組(D組)和對照組(C組)，各32例。全痳誘導前，D組微量泵緩慢靜註右美託咪定0.5μg/kg，C組給予等量生理鹽水，10 min註射完畢。所有患者採用丙泊酚-瑞芬太尼靶控輸註(TCI)全憑靜脈痳醉，術中常規生命體徵鑑測。記錄患者術前(T0)、停TCI即刻(T1)、停TCI後5 min(T2)、自主呼吸恢複(T3)、神誌恢複(T4)、拔管(T5)及拔管後5 min(T6)的BIS指數。分彆記錄停TCI至BIS達65、75、85、95及呼吸恢複、神誌恢複、拔管的時間。比較拔管即刻至拔管後20 min患者不良反應髮生情況。(1)D組T2~T3時BIS值低于C組(<0.05)，T4~T6時與C組無統計學差異(>0.05)。(2)D組BIS值達到65、75的時程明顯長于C組(<0.05)，但D組BIS值達到85和95，以及呼吸恢複、神誌恢複、拔管時間與C組無統計學差異(>0.05)。(3)拔管期，D組嗆咳、躁動、噁心、嘔吐、循環波動髮生例數明顯少于C組(<0.05)。痳醉誘導前預註小劑量右美託咪定，不影響腹腔鏡膽囊切除患者術畢的清醒程度和複囌時間，且有利于減少拔管期不良反應。
연구전빙정맥마취유도전예주소제량우미탁미정대복강경담낭절제환자발관기뇌전쌍빈(BIS)지수화복소정황적영향。64례행택기복강경하담낭절제수술환자수궤분위우미탁미정조(D조)화대조조(C조)，각32례。전마유도전，D조미량빙완만정주우미탁미정0.5μg/kg，C조급여등량생리염수，10 min주사완필。소유환자채용병박분-서분태니파공수주(TCI)전빙정맥마취，술중상규생명체정감측。기록환자술전(T0)、정TCI즉각(T1)、정TCI후5 min(T2)、자주호흡회복(T3)、신지회복(T4)、발관(T5)급발관후5 min(T6)적BIS지수。분별기록정TCI지BIS체65、75、85、95급호흡회복、신지회복、발관적시간。비교발관즉각지발관후20 min환자불량반응발생정황。(1)D조T2~T3시BIS치저우C조(<0.05)，T4~T6시여C조무통계학차이(>0.05)。(2)D조BIS치체도65、75적시정명현장우C조(<0.05)，단D조BIS치체도85화95，이급호흡회복、신지회복、발관시간여C조무통계학차이(>0.05)。(3)발관기，D조창해、조동、악심、구토、순배파동발생례수명현소우C조(<0.05)。마취유도전예주소제량우미탁미정，불영향복강경담낭절제환자술필적청성정도화복소시간，차유리우감소발관기불량반응。
To study the effects of dexmedetomidine preinjection before total intravenous anesthesia induction on bispectral (BIS) index and recovery in patients receiving laparoscopic cholecystectomy (LC) during extubation period. Total 64 patients receiving LC were randomly divided into dexmedetomidine group (group D) and control group (group C) (n=32 per group). Before total intravenous anesthesia induction, small doses of dexmedetomidine were injected by micro pumps in group D (0.5 μg/kg), and normal saline was administered in group C within 10 min. All patients were treated with propofol-remifentanil target controlled infusion (TCI) for total intravenous anesthesia, and intraoperative routine life signs monitoring was provided. The BIS index was recorded before operation (T0), upon stop of TCI (T1), in 5 min after stop of TCI (T2), upon recovery of spontaneous breathing (T3), upon recovery of consciousness (T4), during extubation (T5) and in 5 min after extubation (T6). The time period from the stop of TCI to that when BIS index reached to 65, 75, 85, and 95 and the time points of respiration recovery, extubation, and consciousness recovery were recorded, respectively. The incidences of adverse reactions of patients within 20 min after the extubation were compared between two groups. (1)The BIS values in group D from T2 to T3 were lower than that in group C ( < 0.05), and those from T4 to T6 had no significant difference from those in group C ( >0.05). (2) The time periods for BIS values in group D to reach to 65 and 75 were longer than those in group C ( < 0.05), but those for BIS values in group D to reach to 85 and 95 as well as the time points of respiration recovery, extubation, and consciousness recovery showed no significant difference from those in group C ( >0.05). (3) During the extubation period, the incidences of cough, restlessness, nausea and vomiting, and cycle fluctuations in group D were significantly less than those in group C ( < 0.05). Preinjection of small doses of dexmedetomidine before intravenous anesthesia induction does not affect the postoperative awaking and recovery time of patients receiving LC, but it can reduce adverse reactions during extubation period.
