右美托咪定对七氟醚吸入麻醉妇科腹腔镜手术患者血浆胃动素及术后恶心呕吐的影响  

Effects of Dexmedetomidine on Plasma Motilin Level and Postoperative Nausea and Vomiting in Patients Undergoing Gynecological Laparoscopic Operation under Sevoflurane Inhalation Anesthesia

作　　者：王晓宁[1] 刘丽[1] 张丽红[2] 赵斌江[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院麻醉科,100038 [2]中国医科大学附属盛京医院麻醉科,沈阳110004

出　　处：《医学研究杂志》2014年第5期168-170,共3页Journal of Medical Research

摘　　要：目的观察右美托咪定(DEX)对七氟醚吸入麻醉妇科腹腔镜手术患者血浆胃动素(MTL)及术后恶心呕吐(PONV)的影响。方法妇科腹腔镜手术患者50例,随机分为DEX组(D组)和对照组(C组)。D组予DEX 1μg/kg并以0.2μg/(kg·h)维持,C组则予生理盐水。记录手术、吸入麻醉时间,七氟醚用量,苏醒和气管导管拔除时间;检测术前(T0)、术后24h(T1)和术后48h(T2)血浆MTL水平;随访PONV的发生情况。结果与C组比较,D组七氟醚用量减少(P<0.05),苏醒和气管导管拔除时间无明显延长(P>0.05),T1时点术后MTL水平显著降低(P<0.05)且术后24h内PONV发生率明显降低(P<0.05)。结论七氟醚吸入麻醉妇科腹腔镜手术应用DEX可减少七氟醚用量,不延长苏醒和气管导管拔除时间,减少MTL释放,显著降低PONV发生。Objective To observe the effects of dexmedetomidine on plasma motilin level and postoperative nausea and vomiting in patients undergoing gynecological laparoscopic operation. Methods In this prospective, randomized, double - blind study, 50 ASA Ⅰ and Ⅱ patients undergoing selective laparoseopic myometomy under general anesthesia were included. The patients were randomly alloca- ted to two groups （n = 25） ： dexmedetomidine group （group D） and control group （group C）. Dexmedetomidine was given with 1 μg/kg in 20 ml within 10 min just before induction of anesthesia in group D, and the same volume of normal saline was given in group C in the same way. Then dexmedetomidine was maintained at 0.2μg/（ kg · h） until 10 rain before the end of the operation in group D. Normal sa- line was given at the same maintain speed in group C. Duration of operation and anesthesia, consumption of sevoflurane, emergence time, extubation time were recorded, and the level of plasm motilin was tested at three timepoints： prior to operation（To ） , 24h after operation （T1 ） and 48h after operation（T2 ） , and the occurrence of nausea and vomiting within 48h after operation were also recorded. Results The consumption of sevoflurane and the occurrence of nausea and vomiting within 24h after operation in group D were significantly lower than those in group C（P 〈 0.05 ）. There was no significant difference in emergence time and extubation time between two groups （P 〉 0.05）. The level of plasma motilin at T1 was significantly lower than that in group C （P 〈 0.05 ）. Conclusion Intravenous infusion of dexmedetomidine can reduce the consumption of sevoflurane without prolonging emergence time and extubation time, reduce the release of motilin and significantly lower the occurrence of nausea and vomiting after operation in patients undergoing gynecological laparoseopic oper- ation under sevoflurane inhalation anesthesia.

关 键 词：右美托咪定 腹腔镜检查 妇科外科手术 胃动素 手术后恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]