右旋美托咪啶对鼓室成形术丙泊酚用量及患者苏醒的影响  

Effects of dexmedetomidine on propofol dose and recovery in patients undergoing tympanoplasty

作　　者：叶健鸿[1] 彭俊[2] 杨小宇[1] 黄文起[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广州510080 [2]中山大学孙逸仙纪念医院麻醉科,广州510120

出　　处：《岭南现代临床外科》2012年第2期149-152,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的观察右旋美托咪啶(Dex)对鼓室成形术丙泊酚用量及苏醒期疼痛、躁动的影响。方法 60例ASAⅠ～Ⅱ级择期行鼓室成形术患者随机入选Dex组(D组)和对照组(C组),每组30例。D组麻醉前10min予Dex1μg·kg-1静注、术中以0.3μg·kg-1·h-1恒速输注至术毕前30min;C组则相应静注、恒速输注等量生理盐水(NS)。两组均采用丙泊酚复合瑞芬太尼全凭静脉麻醉,并于Narcotrend监测指导下维持相同麻醉深度。观察并记录使用Dex/NS前后(T0、T1)、头部包扎(T2)、拔管(T3)、拔管后5min(T4)、30min(T5)、术后2h(T6)、6h(T7)的心率及血压;记录丙泊酚用量;记录拔管前后RS、RSS、VAS评分及苏醒期芬太尼追加情况。结果相较于C组,D组丙泊酚总用量减少;T2、T3、T4时点RS评分下降同时RSS评分升高;T4、T5、T6时点VAS评分及苏醒期芬太尼追加率、量均降低(P<0.05)。结论全凭静脉麻醉下鼓室成形术中应用Dex,可减少丙泊酚用量、减轻苏醒期疼痛并减少苏醒期躁动发生。Objective To observe the effects of dexmedetomidine on propofol consumption, postoperative pain and agitation in patients undergoing tympanoplasty. Methods Sixty ASA I or II patients scheduled for tympanoplasty were randomly allocated into two groups （n=30 each）. Dex （group D） was administrated 1 μg·kg-1 intravenously 10 mins before induction and then continuously infused with a rate of 0.3 μg·kg-1·h-1 in group D while normal saline was adopted instead of Dex in control group（group C）.In both groups,anesthesia was induced and maintained with propofol and remifentanil; target concentration of propofol was regulated to keep Narcotrend index （NI） within （46-20） range. BP,HR,propofol consumption,RS,RSS,VAS and fentanyl requirements were recorded and analyzed. Results Propofol consumption during surgery and fentanyl requirements,RS,VAS score during anesthesia recovery were less in group D than in group C while RSS score was higher in group D than in group C（P0.05）. Conclusion Dexmedetomidine can effectively reduce propofol consumption and alleviate the incidence and degree of postoperative pain and agitation in patients undergoing tympanoplasty.

关 键 词：右旋美托咪啶 鼓室成形术 全凭静脉麻醉 术后疼痛 躁动 

分 类 号：R614[医药卫生—麻醉学]