右美托咪定对鼻内镜手术患者血流动力学及苏醒期的影响  

Effect of Intraoperative Dexmedetomidine Infusion on Hemodynamic and Recovery Period after Nasal Surgery

作　　者：李也牧[1] 张亚健[1] 

机构地区：[1]锦州市中心医院,辽宁锦州121001

出　　处：《医学与哲学（B）》2014年第12期47-49,共3页Medicine & Philosophy(B)

摘　　要：探讨鼻内镜手术时应用右美托咪定对其血流动力学及苏醒期的影响。选择100例行鼻内镜的择期手术患者,随机分为两组,右美托咪定组(D组),持续泵入右美托咪定0.4μg·kg-1·h-1从麻醉诱导开始到拔管结束;对照组(C组),持续泵入相同剂量的生理盐水。诱导药物均为依托咪酯0.3mg/kg,舒芬太尼0.4μg/kg,罗库溴铵0.6mg/kg,术中以丙泊酚6mg·kg-1·h-1、瑞芬太尼0.1μg·kg-1·min-1维持。观察并记录诱导前5min,手术开始后10min及30min,手术结束时,拔管时及拔管后2min的MAP及HR;记录术野质量和术中出血量、手术时间和拔管时间、拔管时躁动的发生率、呛咳评分、拔管后患者的Ramsay镇静评分。结果 D组在拔管时及拔管后2min血压和心率与C组相比降低(P<0.05);D组的术野质量优于C组(P<0.05),术中出血量D组少于C组(P<0.05);两组的手术时间和拔管时间差异无统计学意义;拔管时躁动的发生率及呛咳评分D组低于C组(P<0.05);D组拔管后患者的Ramsay镇静评分高于C组(P<0.05)。术中应用右美托咪定,可使鼻内镜手术患者术中血流动力学更稳定,苏醒期更为平稳。To investigate effect of intraoperative dexmedetomidine infusion on hemodynamic and recovery period after nasal surgery in adult patients.One hundred patients undergoing nasal surgery were randomized into two groups.The dexmedetomidine group（Group D,n=50）received dexmedetomidine infusion at a rate of 0.4μg·kg-1·h-1 from induction of anaesthesia until extubation,while the control group（Group C,n=50）received volume-matched normal saline infusion as placebo.Etomidate（0.3mg/kg）,sufentanil（0.4μg/kg）and rocuronium（0.6mg/kg）were used for induction of anaesthesia,propofol（6mg·kg-1·h-1）and remifentanil（0.1μg·kg-1·min-1）was used for maintenance of anaesthesia.HR and MAP were recorded before induction of anaesthesia,10 min after the start of operation,30 min after the start of operation,at the end of operation,at extubation,and 2min after extubation.Quality of operation field and intraoperative blood loss,operating time and extubation time,incidence of agitation and scores of cough during extubation,scores of Ramsay sedation after extubation were recorded.MAP and HR were lower at extubation and 2min after extubation in Group D than Group C;Quality of operation field were better in Group D than Group C;intraoperative blood loss were less in Group D than Group C;there were no statistical significance in operating time and extubation time between two group;the incidence of agitation and scores of cough were lower in Group D than Group C;scores of Ramsay sedation after extubation were higher in Group D compared with Group C.Intraoperative infusion of dexmedetomidine provided more stable hemodynamics and recovery period more smoothly.

关 键 词：右美托咪定 鼻内镜手术 苏醒期 

分 类 号：R614.24[医药卫生—麻醉学]