不同剂量右美托咪定预防全身麻醉患者苏醒期躁动的临床观察  

Clinical observation of different doses of dexmedetomidine on prevention of emergence agitation in general-anesthesia patients

作　　者：严金秀[1] 张学康[1] 熊绪[1] 黎云霞[2] 余桂媛[1] 许庆琴[1] 熊婷[1] 郭瑶[1] 

机构地区：[1]南昌大学第一附属医院麻醉科,南昌330006 [2]江西省人民医院消毒供应中心,南昌330006

出　　处：《中国当代医药》2015年第32期129-132,共4页China Modern Medicine

基　　金：江西省卫生计生委科技计划(20151051)

摘　　要：目的观察不同剂量右美托咪定（DEX）预防麻醉复苏室（PACU）全身麻醉患者苏醒期躁动的效果。方法选择南昌大学第一附属医院2014年6月~2015年6月全身麻醉行腰椎手术术后送入PACU的患者160例,ASA分级Ⅰ~Ⅱ级,随机分成4组,用微量泵分别泵入DEX 0.2μg/kg（D1组）、0.4μg/kg（D2组）、0.6μg/kg（D3组）,泵入等量生理盐水（NS组）。记录4组患者麻醉前（T1）、入PACU给药前即刻（T2）、给药后10 min（T3）、自主呼吸恢复（T4）、吸痰拔管（T5）、拔管后10 min（T6）及出PACU（T7）的血压、心率。记录4组T4、T5、T6和T7 4个时间点的躁动评分（RS评分）、疼痛评分（VAS评分）、镇静评分（Ramsay评分）。记录拔管时间及PACU观察时间。结果 4组在不同时间点血压、心率均有不同程度的波动。D2、D3组T4~T7时间点RS、VAS评分较NS组下降,差异有统计学意义（P〈0.05）。D2、D3组T4~T7时间点Ramsay评分较NS组增高,差异有统计学意义（P〈0.05）。4组拔管时间及PACU观察时间比较差异无统计学意义。结论全身麻醉术后微量泵泵入DEX（0.4~0.6μg/kg）,可有效预防全身麻醉患者苏醒期躁动且不延长拔管时间,提高患者术后安全系数,减少PACU医生、护士的工作量。Objective To observe the effect of different doses of dexmedetomidine（DEX） on prevention of emergence agitation in general-anesthesia patients in postanesthesia care unit（PACU）.Methods From June 2014 to June 2015,160 patients accepted with lumbar surgery after general anesthesia were sent to PACU.According to ASA classification（Ⅰ toⅡ）,they were divided into 4 groups：0.2 μg/kg DEX by micro pump（D1 group）,0.4 μg/kg DEX（D2 group）,0.6 μg/kg DEX（D3 group）,and the same volume of normal saline（NS group）.The blood pressure（BP） and heart rate（HR） before anesthesia（T1）,before medication after being sent to PACU（T2）,10 min after medication（T3）,spontaneous breathing（T4）,sputum suction and tube drawing（T5）,10 min after tube drawing（T6）,and discharging from PACU（T7） were recorded.Agitation score（RS score）,pain score（VAS score）,and sedation score（Ramsay score） in T4,T5,T6 and T7 in these four groups were recorded.The time to withdraw tube and observation time in PACU were also recorded.Results During different time points,both BP and HR displayed fluctuation to a certain degree.In D2 and D3 groups,RS score and VAS score from T4 to T7 were decreased in comparison with those in NS group with statistical differences（P〈0.05）.In D2 and D3 groups,Ramsay score from T4 to T7 was increased compared with that in NS group,which displayed a statistical difference（P〈0.05）.There was no significant difference in time of withdrawing tube and PACU observation time.Conclusion After generalanesthesia surgery,DEX（0.4 to 0.6 μg/kg） by micro pump can effectively prevent emergence agitation.It doesn＇t prolong time of withdrawing tube,improves postoperative safety factor,and reduces the workload of PACU doctors and nurses.

关 键 词：右美托咪定 全身麻醉 躁动 

分 类 号：R614.2[医药卫生—麻醉学]