右美托咪定与瑞芬太尼在声带息肉摘除术中的应用比较  

Application of dexmedetomidine and remifentanil in laryngomicrosurgery

作　　者：杨丹[1] 余庆波[1] 万勇[1] 

机构地区：[1]川北医学院附属医院麻醉科,四川南充637000

出　　处：《川北医学院学报》2015年第2期187-190,共4页Journal of North Sichuan Medical College

基　　金：四川省科技厅项目(120444)

摘　　要：目的:比较右美托咪定和瑞芬太尼在支撑喉镜下声带息肉摘除手术中临床应用效果。方法:将60例择期在支撑喉镜下行声带息肉切除术患者随机分为生理盐水组(NS组)、右美组(D组)和瑞芬组(R组)。D组在麻醉诱导前泵注0.6μg/kg右美托咪定,NS组和R组泵注等量生理盐水。观察记录诱导及术中平均动脉压(mean artery pressure,MAP)、心率(heart rate,HR)、麻醉恢复情况及并发症。结果:NS组在气管插管和置入支撑喉镜后MAP和HR明显高于R组和D组(P<0.05);D组患者围拔管期的视觉模拟评分(vision analog score,VAS)明显低于R组(P<0.05);D组患者并发症发生率明显低于NS组和R组(P<0.05)。结论:在支撑喉镜声带息肉摘除术中,术前泵注0.6μg/kg的右美托咪定有助于术中血流动力学稳定,且无明显不良反应的发生,是一种安全有效的麻醉方法。Objective：To compare the effects of dexmedetomidine and remifentanil in laryngomicrosurgery. Methods：Sixty pa-tients undergoing laryngomicrosurgery were randomly divided into 3 groups：0. 9% sodium chloride injection group （ group NS） ,dexme-detomidine group （ group D） and remifentanil group （ group R） . Before anesthesia induction,group NS and group R were given 0. 9%sodium chloride injection 10 mL,and group D was given 0. 6 μg/kg dexmedetomidine 10 mL,respectively. The mean artery pressure （MAP） and heart rate （HR） were recorded at different time points. The recovery time of spontaneous breath and extubation were recor-ded after operation. The vision analog score （VAS） was recorded immediately at extubation and 5,10,20 and 30 min after tracheal ex-tubation. Results：The hemodynamics in group D and group R were more stable than that in group NS （P〈0. 05）. The VAS after extu-bation in group R was higher than that in group D. The incidence rate of side-effect in group D was much lower than that in group R. Conclusion：A loading dose of 0. 6 μg/kg dexmedetomidine by intravenous infusion before anesthesia can both improve the stability of hemodynamics and the recovery quality,which provides a better condition for tracheal extubation,therefore this method is deserved to be recommended in laryngomicrosurgery.

关 键 词：右美托咪定 瑞芬太尼 支撑喉镜 

分 类 号：R614[医药卫生—麻醉学]