右美托咪啶对口腔颌面手术苏醒期躁动的作用评价  

Effect of dexmedetomidine on emergence agitation after oral and maxillofacial surgery

作　　者：陈志峰[1] 陈源昆[1] 郭勇[1] 姜虹[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院麻醉科,上海200011

出　　处：《上海口腔医学》2013年第6期698-701,共4页Shanghai Journal of Stomatology

摘　　要：目的:评价右美托咪啶(简称右美)对口腔颌面手术苏醒期躁动的作用。方法:全麻下行口腔手术患者55例,术后入苏醒室,随机分为右美组28例,使用右美托咪啶0.3μg/kg静脉推注。对照组27例,使用等量生理盐水静脉推注。评估苏醒期发生躁动情况,记录2组入室后拔除气管导管的时间,记录入苏醒室即刻、入室后5、15、30、60、120 min时平均动脉压、心率、血氧饱和度、镇静评分。采用SAS 9.1软件包对数据进行统计学分析。结果:苏醒期躁动的发生率,右美组(18%)较对照组(70%)显著降低(P<0.05)。入苏醒室后5、15、30、60 min,右美组的Ramsay镇静评分显著高于对照组(P<0.05)。入苏醒室后5、15、30、60、120 min,右美组患者心率较对照组显著下降(P<0.05),入苏醒室后15、30min,右美组患者平均动脉压较对照组显著下降(P<0.05)。2组患者术后拔管时间无显著差异,术后均无呼吸抑制发生。结论:右美托咪啶0.3μg/kg一次静脉推注能安全有效地降低口腔手术苏醒期躁动。PURPOSE： To evaluate the effect of dexmedetomidine on emergence agitation after oral and maxillofacial surgery. METHODS： Fifty five patients who went into recovery room after oral and maxillofacial surgery were randomly divided into 2 groups： dexmedetomidine group （n=28） and control group （n=27）. Patients in dexmedetomidine group were assigned to receive intravenous dexmedetomidine at a dose of 0.3 p^g/kg when they came into recovery room. Patients in control group were assigned to reeeive intravenous normal saline. Emergence agitation was assessed and extubation time after operation was recorded. Mean arterial pressure, heart rate, arterial oxygen saturation, Ramsay scale were recorded at the time point of entering the recovery room instantly（T0） and 5 minutes（T1）, 15 minutes（T2）, 30 minutes（T3）, 60 minutes （T4）, 120 minutes （T5） after the patient came into recovery room. Statistical analysis was performed using SAS 9.1 software package. RESULTS： The incidence of emergence agitation was significantly lower in the dexmedetomidine group （18%） than in the control group （70%） （P〈0.05）. The Ramsay scale was significantly higher in dexmedetomidine group than in the control group at the time point of T1, T2, T3, T4 （P〈0.05）. The heart rate was significantly lower in dexmedetomidine group than in the control group at the time point of T1, T2, T3, T4, T5 （P〈O.05）. Mean arterial pressure was significantly lower in dexmedetomidine group than in the control group at the time point of T2, T3 （P〈0.05）. There was no significant difference on extubation time between 2 groups. There was no postoperative respiratory depression in 2 groups. CONCLUSIONS： Intravenous dexmedetomidine at a dose of 0.3 μg/kg can reduce emergence agitation ＇,after oral and maxillofaeial surgery with safety and efficacy.

关 键 词：右美托咪啶 口腔颌面手术 苏醒期躁动 

分 类 号：R614[医药卫生—麻醉学]