右旋美托咪啶与咪达唑仑联合芬太尼在阑尾切除术中的作用比较  

Efffects of Dexmedetomidine compare with midazolam combined with fentanyl in appendectomy

作　　者：肖颖琨[1] 许立新[1] 李天远 阮祥才[1] 佘守章[1] 何莉[1] 苏健[1] 

机构地区：[1]广州市第一人民医院麻醉科,广州510180

出　　处：《北方药学》2015年第8期100-101,共2页Journal of North Pharmacy

摘　　要：目的：比较右旋美托咪啶与咪达唑仑复合芬太尼用于硬膜外麻醉下阑尾切除术后苏醒时间以及不良反应。方法：选取2013年1月~2014年10月我院收治的60例硬膜外麻醉下阑尾切除手术患者,根据电脑产生序列号随机分为两组,咪达唑仑复合芬太尼组（M组,n=30）和右旋美托咪啶组（D组,n=30）,观察并记录患者给药前、给药后15min、分离阑尾时以及阑尾切除后5min时的MAP、HR、SPO2和术后苏醒时间以及不良反应。结果：两组MAP和SPO2差异无统计学意义（P〉0.05）.D组HR减慢较M组明显（P〈0.05）。D组较M组苏醒时间明显缩短,同时明显降低恶心、呕吐、呼吸抑制的发生率,差异有统计学意义（P〈0.05）,窦性心动过缓两组发生率差异无统计学意义（P〉0.05）。结论：右旋美托咪啶用于硬膜外麻醉下阑尾切除术,较咪达唑仑复合芬太尼苏醒更快,副作用更小。Objective：To compare the effect of dexmedetomidine on the recovery time and adverse reaction with midazolam combined with fentanyl in epidural anesthesia appendectomy. Methods：For this prospective and randomized trial,approval was obtained from the Ethical Committee and informed consent from their parents.A total of 60 patients undergoing epidural anesthesia appendectomy at Guangzhou First People＇s Hospital between January 2013 and October 2013 were collected,and randomly divided into two groups,midazolam and fentanyl group（M group,n =30） and dexmedetomidine group（D group,n =30）.MAP,HR,SPO2 were observed and recorded before administration,15 min after administration,during dragging appendix and 5min after appendectomy at the same time,postoperative recovery time and adverse reaction were also recorded. Results：There were no significant differences in MAP and SPO2 between the groups during the operation.（P0.05）HR was significantly decreased in the D group higher than M group（P0.05）.The recovery time was significantly shorter in the D group compared with the M group,and significantly reduce the incidence of nausea,vomiting,respiratory depression（P 0.05）,There were no significant differences in the incidence of sinus bradycardia（P 0.05）. Conclusion：Dexmedetomidine can shorter the recovery time and decreased adverse reactions compared with midazolam and fentanyl group in appendectomy.

关 键 词：右旋美托咪啶 阑尾炎 硬膜外麻醉 牵拉反射 

分 类 号：R656.8[医药卫生—外科学]