右美托咪啶对后腹腔镜术后患者苏醒期的影响  

Effect of dexmedetomidine on postoperative recovery of patients after retroperitoneal laparoscopy.

作　　者：皮名芳[1] 陈春[1] 侯俊[1] 林雷[1] 唐万英[1] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院麻醉科,湖北宜昌443003

出　　处：《海南医学》2013年第3期374-376,共3页Hainan Medical Journal

摘　　要：目的探讨右美托咪啶对后腹腔镜手术患者术后苏醒期的影响。方法选择50例ASAⅠ～Ⅱ级择期行后腹腔镜手术患者，采用随机对照方法分为实验组和对照组各25例。实验组患者在关气腹时给予右美托咪啶0．5rtg／kg微量泵泵注，10min左右泵注完毕，对照组泵注等剂量的生理盐水作对照。观察患者停用麻药时（T0）、拔管时（T1）、拔管后5min（T2）、拔管后10min（T3）几个时段的平均动脉压（MAP）、心率（HR）变化，记录术毕患者自主呼吸恢复时间、呼之睁眼时间、拔管时间及术后警觉／镇静评分（OAA／S评分）和躁动情况。结果实验组MAP、HR在拔管时、拔管后5min明显低于对照组（P〈0．05），而且术后躁动发生率及OAA／S评分也明显低于对照组（P〈0．05）；但两组术毕自主呼吸恢复时间、呼之睁眼时间和拔管时间比较差异无统计学意义（P〉0．05）。结论右美托咪啶可有效抑制患者苏醒拔管期的应激反应，起到了良好的术后镇静作用，从而降低了苏醒期躁动发生率，提高苏醒质量。Objective To investigate the effect ofdexmedetomidine on postoperative recovery of patients af-ter retroperitoneal laparoscopy. Methods Fifty patients ofASA Ⅰ～Ⅱ grade scheduled for retroperitoneal laparosco-py were randomly divided into two groups： the study group （n=25） and the control group （n=25）. Patients in the study group were given micro infusion pump of dexmedetomidine 0.5 μg/kg for 10 min when closed pneumoperitoneum, while those in the control group were given the dose of saline. The change of mean arterial pressure （MAP） and heart rate （HR） were observed at drug withdrawal （T0）, extubation （T1）, 5 min after extubation （T2）, and 10 min after extuba-tion （T3）. Spontaneous breathing recovery time, time to eye opening, extubation time, OAA/S score and restlessness were recorded. Results The MAP, HR in the study group was significantly lower than those in the control group at T1 and T2 （P〈0.05）, and the incidence of postoperative restlessness and OAA/S score in the study group were also sig- nificantly lower （P〈0.05）. There was no statistically significant difference between the two groups in spontaneous breathing recovery time, time to eye opening and extubation time （P〉0.05）. Conclusion Dexmedetomidine can in-hibit extubation of the stress response effectively and produce a satisfactory postoperative sedation, which reduces the incidence of restlessness and improve the quality of recovery.

关 键 词：右美托咪啶 后腹腔镜手术 苏醒期 

分 类 号：R656[医药卫生—外科学]