持续静注右美托咪定对腹腔镜下宫颈癌根治术患者全麻恢复期的影响  

Effect of dexmedetomidine by continuous intravenous infusion on the recovery process of patients undergoing laparoscopic radical hysterectomy surgery under general anesthesia

作　　者：曾和清[1] 易理生 肖文军[1] 

机构地区：[1]长沙市妇幼保健院,长沙410007

出　　处：《实用肿瘤学杂志》2016年第2期135-139,共5页Practical Oncology Journal

摘　　要：目的观察右美托咪定持续静脉注射对腹腔镜下宫颈癌根治术患者全麻恢复期的影响。方法择期全麻腹腔镜下宫颈癌根治术患者80例，ASAI-Ⅱ级，随机分为C、D两组，在手术开始前10min至术毕前20min，分别泵注生理盐水（C组）和右美托咪定（D组）0．6μg．kg-1．h-1。监测患者麻醉前（T1）、拔管前（T2）、拔管时（T1）、拔管后5rain（T4）、拔管后10min（L）时心率（HR）、平均动脉压（MAP）。采用t检验、X2检验、重复测量资料的方差分析或Mann—WhitneyU检验方法比较两组患者恢复时间、呛咳评分、镇静-躁动评分（SAS评分）、Ramsay镇静评分、不良反应及用药情况。结果与C组比较，D组拔管前后心率、血压波动较小，Ramsay评分高。拔管前和拔管后D组呛咳评分和SAS评分低于C组（P〈0．05）。D组躁动、心动过速发生率低于C组（P〈0．05），心动过缓发生率高于C组（P〈0．05）。D组七氟醚用量和术后追加芬太尼量均少于C组（P〈0．05）。结论持续静脉泵注右美托咪定可明显减少拔管不良反应和m流动力学波动，不延长恢复时间，有利于麻醉恢复。Objective To investigate the influence of dexmedetomidine by continuous intravenous infu- sion on the recovery process of patients undergoing laparoscopic radical hysterectomy surgery under general anes- thesia. Methods Eighty patients, ASA I - II, scheduled for laparoscopic radical hysterectomy surgery under general anesthesia, were randomized into group C and group D. Normal saline and dexmedetomidine at the dose of 0.6 μg. kg-1. h-1 were injected into different groups from 10 mins before the operation to20 rains before the end of operation respectively. Heart rate （ HR）, mean arterial pressure （MAP） were recorded at following five time points ： before anesthesia （ TI ）, 10 mins before extubation （ T2 ）, extubation （ T3 ）, 5 mins after extubation （ T4 ）, 10 mins after exbubation（ T5 ）. The recovery time, cough reflex score, sedation - agitation scale （ SAS）, Ramsay score, the occurrence rate of untoward effect and the dosage of medication were observed. The observational indi- ces were analyzed by using t - test, chi - square test, repeated measures data of ANOVA or the Mann - Whitney u test method. Results Compared with group C, during the recovery process, MAP and HR in group D was more stable. Ramsay score in group D was higher（P 〈0.05）. The SAS in group D was lower（P 〈0.05）. The sedation - agitation scale in group D was lower（ P 〈 0.05 ）. The occurrence rate of agitation and tachycardia was lower in group D（ P 〈 0.05 ）. But the occurrence rate of bradycardia was higher（ P 〈 0.05 ）. Meanwhile, usage amount of sevoflurane was lower in group D （ P 〈 0.05 ）. Conclusion Dexmedetomidine continuous intravenous infusion re- duced the untoward effect of extubation, did not extend extubation time, and kept more stable haemodynamies.

关 键 词：右美托咪定 腹腔镜 宫颈癌根治术 全身麻醉 

分 类 号：R614.3[医药卫生—麻醉学]