右美托咪定对鼻内窥镜手术患者血流动力学和躁动的影响  

Effects of dexmedetomidine on haemodynamics and agitation of patients under nasal endoscopy surgery

作　　者：余理想[1] 赵海波[1] 姜蕾[1] 邱承忠[1] 

机构地区：[1]东南大学医学院附属南京同仁医院麻醉科,江苏南京211102

出　　处：《中国新药与临床杂志》2013年第12期956-959,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的评价右美托咪定对鼻内窥镜下鼻腔手术患者血流动力学和躁动的影响。方法择期鼻内窥镜下行鼻腔手术患者60例．ASAI或Ⅱ级，随机分为两组，每组30例。麻醉诱导前，右美托咪定组在10min内静脉泵注右美托咪定1．0μg·kg-（用氯化钠注射液稀释至50mL），麻醉诱导后以0．5～0．8μg·kg-·h-持续泵入至手术结束前30min。对照组以同样方式泵注氯化钠注射液。两组其他麻醉方法相同。记录入室时（E，）、插管前（T。）、停用右美托咪定（T：）、拔管即刻（T3）、拔管后10min（T4）和1h（T，）的心率（HR）和平均动脉压（MAP）。记录1r3时镇静一躁动（SAS）评分及B、T，时Ramsay镇静评分，观察合并用药和不良反应发生情况。结果两组1r0、T：和T。时HR和MAP无显著差异（P〉0．05），右美托咪定组T，、L和B时HR和MAP低于对照组（P〈0．05）。T，时右美托咪定组SAS评分低于对照组．而Ramsay评分高于对照组，差异均有显著意义（P〈0．05）；T，时右美托咪定组Ramsay评分低于对照组（P〈0．05）。术中右美托咪定组丙泊酚和瑞芬太尼用量少于对照组，但应用阿托品16例（53％），多于对照组（5例，17％，P〈0．05）。T，时右美托咪定组发生呛咳1例（3％），对照组发生13例（43％），差异显著（P〈0．05）。结论右美托咪定可明显减少鼻内窥镜下鼻腔手术患者麻醉恢复期及术后躁动的发生，维持患者血流动力学稳定。AIM To evaluate the effect of dexmedetomidine （ patients undergoing nasal endoscopic surgery. METHODS Sixty ASA Dex） on haemodynamics and agitation in I or I1 patients with selective endoscopic surgery were randomly divided into Dex group and control group （30 in each）. All patients received the same anesthesia induction and maintenance. In the Dex group, Dex 1 μg.kg-1 （diluted with sodium chloride injection to 50 mL） were injected intravenously during 10 rain, following by 0.5 - 0.8 μg＇kg-l＇h-1 continuously till to 30 min before the operation finished. In the control group, sodium chloride injection was given at the same maneuver. The heart rate （HR） and mean arterial pressure （MAP） were detected at patients arrived operation room （To）, before tracheal intubation （T1）, at 10rain （T2） of injection Dex, at extubation time （T3） and 10 min （T4）, 1 hour （Ts） after extubation. Sedation-agitation scale （SAS） at T3, Ramsay scale at T3 and T5 were recorded. Adverse drug reaction and drug combination were also observed. RESULTS HR and MAP of the Dex group were lower significantly compared with those of the control group at T~, T3, T5 （P 〈 0.05） and no significant difference between two groups at To, T2, T4. SAS score at T3 of the Dex group was significantly lower than that of the control group, however Ramsay scale score of the Dex group were higher at T3 and lower at T5 than those of the control group （P 〈 0.05）. The total doses of propofol or remifentanil in the Dex group were less than those in the control group （P 〈 0.05）. There are 16 patients （53%） used atropine in the Dex group, while 5 patients （17%） in the control group, with significant difference （P 〈 0.05）. The cough occurred rate of the Dex group was lower compared with the control group at T3 （3% vs. 43%, P 〈 0.05）. CONCLUSION Dex injection intravenously can reduce postoperative emergence agitation and maintain haemodynamics stability during nasal endoscopic surgery.

关 键 词：右美托咪定 内窥镜 血流动力学 躁动 

分 类 号：R971[医药卫生—药品]