咪达唑仑和右美托咪定抑制七氟醚麻醉苏醒期躁动的对比观察  

Comparative Observation of the Inhibiting Effects Between Midazolam and Dexmedetomidine on Postoperative Agitation with Sevoflurane Anesthesia

作　　者：杨远胡 吉锦泉[2] 龚益淼 姜永立 

机构地区：[1]惠州市惠阳三和医院麻醉科,广东惠州516213 [2]广东省人民医院麻醉科,广东广州510030

出　　处：《中外医疗》2014年第20期106-107,共2页China & Foreign Medical Treatment

摘　　要：目的观察咪达唑仑、右美托咪定对七氟醚全身麻醉术后躁动的作用。方法选取该院普外科全身麻醉手术病人180例,年龄25-60岁,按数字表法随机分为A组、B组、C组,每组60例,麻醉维持和诱导均采用七氟醚-瑞芬太尼。手术结束前15 min A组静脉推注右美托咪定1μg/kg（5 min）,B组静脉推注咪达唑仑0.05 mg/kg,C组静脉推注0.9%生理盐水10 mL,记录给药即刻、给药后5 min、给药后10 min患者血压、心率以及3组患者的手术时间、麻醉时间、苏醒时间、麻醉后苏醒恢复室时间、评估苏醒期躁动分级。结果 A、B组患者麻醉苏醒时间、术后躁动发生率均低于C组患者,差异有统计学意义（P﹤0.05）,且A组患者麻醉苏醒时间、术后躁动发生率低于B组患者,差异有统计学意义（P﹤0.05）,3组患者手术期呼吸、循环的各项指标比较,差异无统计学意义（P﹥0.05）,手术时间、麻醉时间及苏醒后恢复室时间,差异无统计学意义（P﹥0.05）。结论临床剂量右美托咪定对七氟醚-瑞芬太尼全身麻醉苏醒期躁动疗效效果优于咪达唑仑。Objective To observe the roles of midazolam and dexmedetomidine in postoperative agitation after sevoflurane anesthesia. Methods 180 patients aged from 25-60, underwent general anesthesia in Department of General Surgery of hour hospital were selected and randomly divided into group A, group B and group C with 60 cases in each according to digital table method.All patients were induced and maintained by sevoflurane-remifentanyl general anesthesia. 15 minutes before the end of the operation, the patients in group A were intravenous administration dexmedetomidine 1μg/kg（5min）, while group B with midazolam0.05mg/kg, group C intravenous injection of 0.9% saline 10ml. The BP and HR were recorded at the time point of as soon as administration of drugs, 5 and 10 minutes after administration. The time of operation, anesthesia, postanaesthetic recovery and staying in the recovery room was also been recorded. Scores on postoperative emergence agitation were accessed to calculate the effect of drugs. Results The time of postanaesthetic recovery and incidence of postoperative agitation in group A and group B were lower than those in group C（P〈0.05）, and those in group A were lower than those in group B（P〈0.05）. There were no significantly differences between the three groups of patients in the indexes of respiration and circulation during the operation（P〈0.05）, the differences in operation time, anesthesia time and time of staying in the recovery room between the three groups were not statistically significant（P〈0.05）. Conclusion The effect of clinical dose of dexmedetomidine on sevoflurane-remifentanil general anesthesia emergence agitation is better than that of midazolam.

关 键 词：七氟醚 咪达唑仑 右美托咪定 术后躁动 

分 类 号：R614[医药卫生—麻醉学]