右美托咪定对鼻窦手术患者血流动力学及麻醉恢复质量的影响  

Effects of Dexmedetomidine infusion on hemodynamics and recovery quality in sinus surgery

作　　者：朱卓丽[1] 邓玉萍[1] 黄焕森[1] 

机构地区：[1]广州医科大学附属第二医院麻醉科,广东广州510260

出　　处：《中国医药导报》2016年第7期4-7,11,共5页China Medical Herald

基　　金：国家自然科学基金资助项目(81402400);广东省广州市医药卫生科技项目(2015A013010052)

摘　　要：目的观察持续输注不同剂量右美托咪定对内镜鼻窦手术中血流动力学、麻醉复苏质量的影响。方法选择广州医科大学附属第二医院2014年6月~2015年3月择期内镜鼻窦手术成年患者60例,按照随机数字表法分为三组,每组各20例,D1组、D2组于术前泵注右美托咪定负荷剂量0.5μg/kg,随后分别予0.2、0.5μg/（kg·h）持续泵注至手术结束,C组给予同容量生理盐水。记录各组麻醉药用量、血流动力学变化、复苏时间、复苏期Ricker镇静-躁动评分（SAS）、躁动评分（EA）及不良事件。结果 D1组及D2组丙泊酚用量少于C组（P〈0.05）,D2组瑞芬太尼用量少于D1组及C组（P〈0.05）。D1组、D2组在气管插管后即刻、术中及气管拔管时收缩压（SBP）、舒张压（DBP）及心率（HR）均较C组降低（P〈0.05）。气管拔管时D2组患者SAS、EA评分低于C组及D1组（P〈0.05）。D2组患者恶心、寒颤的发生率少于C组及D1组（P〈0.05）。结论内镜鼻窦手术持续输注0.5μg/（kg·h）右美托咪定,有利于维持血流动力学平稳,不延长麻醉复苏时间,减少术中丙泊酚及瑞芬太尼用量。Objective To observe the effects of continuous infusion of different doses Dexmedetomidine（Dex） on hemodynamics, recovery quality in patients undergoing endoscopic sinus surgery. Methods From June 2014 to March 2015,in the Second Affiliated Hospital of Guangzhou Medical University, 60 patients scheduled for elective endoscopic sinus surgery in t were selected, they were divided into three groups, according to random number table. 0.5 μg/kg Dex was infused within 10 min in group D1 and group D2 before anesthesia induction, sodium chloride was infused at the same volume in group C. Propofol and Remifentanil consumption, blood pressure, heart rate（HR）, recovery time, Riker Sedation-Agitation scale（SAS）, Emergence agitation scale（EA） and recovery period adverse events of three groups were recorded. Results Compared with group C, the requirement for Propofol was significantly decreased in group D1 and group D2（P 〈 0.05）. Consumption of Remifentanil was significantly lower in group D2 compared with group D1 and group C（P 〈 0.05）. SBP, DBP and HR in group D1 and group D2 were significantly lower that those in groups C during intubation and extubation（P 〈 0.05）. Compared with group C and group D1,the SAS and EA scale decreased in group D2 at extubation（P 〈 0.05）. The incidence of nausea and shiver were lower in group D2 compared with group D1 and group C（P 〈 0.05）. Conclusion Dexmedetomidine at a dose of 0.5 μg/（kg·h） can effectively attenuate the cardiovascular side effects for patients undergoing endoscopic sinus surgery, attenuate the stress response induction and rapid recovery during anesthesia. Additionally it can reduced the consumption of Propofol and Remifentanil.

关 键 词：右美托咪定 静脉输注 内镜鼻窦手术 NARCOTREND指数 血流动力学 

分 类 号：R614[医药卫生—麻醉学]