右美托咪定预防悬雍垂腭咽成型术患者全身麻醉恢复期躁动的效果  

Efficacy of dexmedetomidine in preventing agitation during recovery from general anesthesia in patients undergoing uvulopalatopharyngoplasty

作　　者：孟小燕[1] 贾瑞芳[1] 左明章[1] 许辉杰[2] Meng Xiaoyan;Jia Ruifang;Zuo Mingzhang;Xu Huijie(Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China;Department of Otolaryngology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China)

机构地区：[1]国家老年医学中心麻醉科,北京医院100730 [2]国家老年医学中心耳鼻喉科,北京医院100730

出　　处：《中华麻醉学杂志》2018年第10期1166-1168,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价右美托咪定预防悬雍垂腭咽成形术患者全身麻醉恢复期躁动的效果。方法择期行悬雍垂腭咽成形术的阻塞性睡眠呼吸暂停综合征患者60例,ASA分级Ⅰ或Ⅱ级,年龄24~62岁,BMI24~37kg/m^2,采用随机数字表法分为右美托咪定组(D组)和常规组(C组),每组30例。D组于麻醉诱导前10min静脉输注负荷剂量的右美托咪定0.8μg/kg,输注时间10min,然后以0.4μg·kg^-1·h^-1的速率静脉输注30min,C组静脉输注生理盐水。麻醉诱导和维持采用靶控输注丙泊酚复合瑞芬太尼,术中维持BIS值40~60。当患者自主呼吸完全恢复,可呼之睁眼且对指令有反应后拔除气管导管,转移至恢复室面罩吸氧。记录苏醒时间、拔除气管导管时间和躁动发生情况,入恢复室后30min时采用词语等级量表评分法评价患者疼痛程度。结果与C组比较,D组躁动发生率降低,疼痛程度减轻,苏醒时间延长(P<0.05);2组患者拔除气管导管时间比较差异无统计学意义(P>0.05)。结论右美托咪定可有效预防悬雍垂腭咽成形术患者全身麻醉恢复期躁动的发生。Objective To evaluate the efficacy of dexmedetomidine in preventing agitation during recovery from general anesthesia in patients undergoing uvulopalatopharyngoplasty(UPPP). Methods Sixty adults patients with obstructive sleep apnea syndrome, of American Society of Anesthesiology physical status Ⅰor Ⅱ, aged 24-62 yr, with body mass index of 24-37 kg/m^2, undergoing elective UPPP, were divided into dexmedetomidine group(group D)and conventional group(group C)using a random number table method, with 30 patients in each group.Dexmedetomidine was infused in a loading dose of 0.8 μg/kg over 10 min starting from 10 min before anesthesia induction, followed by a continuous infusion of 0.4 μg·kg^-1·h^-1 for 30 min in group D, while the equal volume of normal saline was given instead of dexmedetomidine in group C. Anesthesia was induced and maintained by target-controlled infusion of propofol and remifentanil, and bispectral index value was maintained at 40-60 during surgery.Patients were extubated after they restored spontaneous breathing completely, opened eyes on verbal command and responded to verbal command, and then the patients were transferred to the recovery room, and oxygen was inhaled by mask.The emergence time, extubation time and development of agitation were recorded.Verbal rating scale was used to assess pain at 30 min after patients were transferred to the recovery room. Results Compared with group C, the incidence of agitation was significantly decreased, pain was reduced, and the emergence time was prolonged in group D(P<0.05). There was no significant difference in extubation time between two groups(P>0.05). Conclusion Dexmedetomidine can effectively prevent the occurrence of agitation during recovery from general anesthesia in patients undergoing UPPP.

关 键 词：右美托咪啶 睡眠呼吸暂停 阻塞性 耳鼻喉外科手术 麻醉恢复期 躁动 

分 类 号：R614[医药卫生—麻醉学]