右美托咪定和曲马多对全麻苏醒影响的比较研究  

Comparison of the Effect of Dexmedetomidine and Tramadol on Recovery after General Anesthesia

作　　者：谢亚明[1] 曾真[1] 包艳屏 陈慧娣[1] 陶冬青[1] 

机构地区：[1]上海交通大学附属第六人民医院麻醉科,上海200235

出　　处：《中国临床医学》2014年第4期454-456,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:观察麻醉诱导后预注射右美托咪定和曲马多对全麻患者苏醒质量的影响。方法:将60例在膝关节镜下行前或后交叉韧带损伤修复重建的患者随机分为A、B、C组,每组20例。在B超引导下行股神经阻滞和坐骨神经阻滞后行喉罩全身麻醉,手术过程中用七氟醚维持麻醉,手术结束时停止吸入七氟醚。A、B、C组于喉罩置入后手术前分别给予0.9%氯化钠注射液20 mL、曲马多2 mg/kg、右美托咪定0.5μg/kg,曲马多和右美托咪定均用0.9%氯化钠注射液稀释至20 mL。术后将患者送复苏室,记录并比较两组患者拔除喉罩时间以及入室后5 min、15 min、30 min、60 min时的寒战发生率、疼痛评分、镇静评分以及恶心、呕吐发生率。结果:A、B、C组拔除喉罩时间差异无统计学意义;入复苏室后5 min A组的寒战评分高于B、C组(P<0.05),其余时间各组间寒战发生率差异无统计学意义;入复苏室后15 min时C组镇静评分低于A组(P<0.05),而5min、30min、60 min时3组镇静评分差异无统计学意义;3组疼痛评分差异无统计学意义;B组恶心、呕吐发生率高于其他组(P<0.05);A组拔除喉罩后处理躁动时异丙酚的应用率高于B、C组(P<0.05)。结论:预注射右美托咪定及曲马多均能减少全麻苏醒期躁动的发生,应用右美托咪定患者恶心、呕吐发生率较曲马多低。Objective：To evaluate the effect of dexmedetomidine and tramadol injected after anesthesia induction on quality of recovery after general anesthesia.Methods：Sixty patients who underwent anterior or posterior cruciate ligament reconstruction by arthroscopy were randomly assigned into Group A,Group B and Group C.All patients received general anesthesia with laryngeal mask airway after ultrasound-guided femoral nerve block and sciatic nerve block.Sevoflurane was used to maintain anesthesia during operation.Inhalation of sevoflurane stopped once the operation finished.Patients in Group A,Group B and Group C were injected 0.9％ sodium chloride 20 mL,tramadol 2 mg/kg diluted with 0.9％ sodium chloride 20mL,dexmedetomidine 0.5 μg/kg diluted with 0.9％ sodium chloride 20 mL,respectively.Patients were sent to the recovery room after operation.The time of removing laryngeal mask airway,as well as pain score,sedation score,and the incidences of shivering,nausea and vomit at 5 min,15 min,30 min and 60 min in recovery room were recorded and compared.Results：There was no significant difference in the time of removing laryngeal mask airway among the three groups.The incidence of shivering at 5 min in recovery room was higher in Group A than that in Group B and Group C （P＜0.05）,but there was no statistically significant difference among the three groups at other times.The sedation score at 15 min in Group C was lower than that in Group A （P＜0.05）,but there was no statistically significant difference among the three groups at other times.The incideneces of nausea and vomit in Group B was higher than that in other groups （P＜0.05）.The percentage of propofol application for agitation in Group A was higher than those in Group B and Group C after removing laryngeal mask airway （P＜0.05）.Conclusions：Preoperative injection of dexmedetomidine and tramadol could reduce the occurrence of agitation.Patients who were treated with dexmedetomidine have lower incidence of nausea and vomit than those treated wi

关 键 词：右美托咪定 曲马多 关节镜 全身麻醉 

分 类 号：R614.21[医药卫生—麻醉学]