右美托咪定和喉罩通气在经尿道钬激光碎石术全麻的应用  

Application of dexmedetomidine and laryngeal mask airway in general anesthesia for transurethral holmium laser lithotripsy

作　　者：郑洁[1] 胡滨[1] 刘庆[1] 

机构地区：[1]泸州医学院附属中医院麻醉科,四川省646000

出　　处：《江苏医药》2015年第1期69-71,共3页Jiangsu Medical Journal

摘　　要：目的观察右美托咪定联合喉罩通气在全麻经尿道钬激光碎石术(TUHLL)的应用效果。方法全麻下行TUHLL患者80例随机均分为4组。B、C组诱导前10min静脉输注右美托咪定0.5μg/kg。A、B组气管插管;C、D组实施喉罩通气。麻醉诱导采用咪达唑仑0.04mg/kg、舒芬太尼0.3μg/kg、丙泊酚2mg/kg和顺阿曲库铵0.12mg/kg静注;泵注丙泊酚6mg·kg-1·h-1维持麻醉。记录围麻醉期MAP和HR变化,比较麻醉后不良反应。结果麻醉期C、D组的HR和MAP均低于气管插管A、B组(P<0.05),B、C组的HR和MAP低于A、D组(P<0.05)。B、C组术后躁动发生率低于A、D组(P<0.05),C、D组术后咽痛发生率低于A、B组(P<0.05)。结论全麻诱导前应用右美托咪定联合喉罩通气能麻醉维持平稳,减少不良反应,是短小手术麻醉的良好选择。Objective To observe the outcomes of combined use of dexmedetomidine and laryngeal mask airway（LMA）in the patients undergoing transurethral holmium laser lithotripsy（TUHLL）under general anesthesia.Methods Eighty TUHLL patients were equally randomized into4 groups.Dexmedetomidine 0.5μg/kg was infused in 10 min before induction of anesthesia in groups of B and C.Routine endotracheal intubation was performed in groups of A and B and the patients in groups of C and D were ventilated with LMA.Anesthesia was induced with injection of midazolam0.04mg/kg,sufentanil 0.3μg/kg,propofol 2mg/kg and cisatracurium 0.12mg/kg and maintained with propofil 6mg·kg^-1·h^-1 infusion.The changes of MAP and HR were recorded and postoperative adverse responses were compared among 4groups.Results During anesthesia,the changes of MAP and HR were less in groups of C and D than those in groups of A and B（P〈0.05）,which were less in groups of B and C than those in groups of A and D（P〈0.05）.The incidence of restlessness during awakening was less in groups of B and C than that in groups of A and D（P〈0.05）.The incidence of postoperative sore throat was less in groups of C and D than that in groups of A and B（P〈0.05）.Conclusion Combined use of dexmedetomidine and LMA is helpful in keeping stable anesthesia and reducing anesthesia-related adverse responses,which is suitable for short operations.

关 键 词：右美托咪定 喉罩 钬激光碎石 

分 类 号：R614[医药卫生—麻醉学]