右美托咪定对妇科腹腔镜手术患者麻醉恢复的影响  

Effect of dexmedetomidine on anaesthesia recovery in patients undergoing gynaecological laparoscopic surgery

作　　者：顾伟[1] 顾小萍[1] 马正良[1] 业光衡[1] 王杨[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,210008

出　　处：《临床麻醉学杂志》2011年第12期1176-1178,共3页Journal of Clinical Anesthesiology

摘　　要：目的评价右美托咪定对妇科腹腔镜手术患者麻醉恢复的影响。方法妇科腹腔镜手术患者60例,随机均分为三组。D1、D2组术毕前30min分别给予右美托咪定0.4、0.8μg/kg,C组患者给予等量生理盐水。患者均采用静-吸复合麻醉。记录患者入室时(T0)、苏醒时(T1)、拔管时(T2)和离开PACU时(T3)的HR和MAP。记录苏醒时间、拔管时间和离开PACU时间,以及苏醒和拔管时Ramsay镇静评分和Riker躁动评分,术后呕吐、寒战等不良反应,追加芬太尼的例数。结果 D1、D2组拔管时间明显短于C组(P<0.05)。D2组患者恢复期追加芬太尼例数明显少于C组(P<0.05)。苏醒时D2组Ramsay评分明显高于C组和D1组(P<0.05),Riker评分明显低于C组和D1组(P<0.05)。与T0时比较,T1、T2时C组HR明显增快(P<0.05);T2时D1组HR明显增快(P<0.05);D2组HR变化差异无统计学意义;T2时C组MAP显著升高(P<0.05),且C组和D1组明显高于D2组(P<0.05);D2组MAP变化差异无统计学意义。结论妇科腹腔镜手术结束前30min给予右美托咪定0.8μg/kg可减少术后躁动,血流动力学稳定,不影响恢复时间。Objective To evaluate the effect of dexmedetomidine （DEX） on the anaesthesia recovery in patients undergoing gynaecological laparoscopic surgery. Methods Sixty patients scheduled for gynaecological laparoscopic surgery were randomly assigned to three groups （n=20 per group）. Group D1 and group D2 received dexmedetomidine 0. 4μg/kg and 0. 8μg/kg infused 30 rain before the end of surgery, respectively, while group C received equal volume of normal saline as control. Anesthesia was maintained with combined intravenous-inhalational technique in all groups. HR and MAP were recorded at the following time points： arriving at OR （T0）, eyes opening （T1）, tracheal extubation （T2）, and discharge from PACU （T3） the time for emergence, extubation, and duration in PACU were also recorded. Ramsay sedation scale and Riker agitation scale during emergence and extubation, postoperative adverse events such as vomiting or shivering, and cases requiring analgesic rescue with fentanyl were recorded. Results Extubation time in group D1 and D2 was shorter than that in group C （P（0. 05）. Cases requiring rescue dose of fentanyl in group D2 were fewer than those in group C （P（0. 05）. Ramsay scores were higher and Riker scores were lower in group D2 than in group C and group D1 during emergence （P（0. 05）. Compared with baseline HR at To, HR was increased at T1 and T2 in group C, and at T2 in group D1 （P〈0. 05）, while changes of HR in group D2 had no significant difference. MAP at T2 was increased in group C, and was higher in group C and group D1 than in group D2 （P〈0. 05）, while changes of MAP in group T2 had no significance. Conclusion Dexmedetomidine 0. 8μg/kg administered 30 minutes before the end of gynaecologieal laparoseopic surgery could alleviate postoperative agitation and stabilize hemodynamies without prolonging the recovery time.

关 键 词：右美托咪定 麻醉恢复 术后躁动 妇科腹腔镜手术 

分 类 号：R614[医药卫生—麻醉学]