右美托咪定和哌替啶预防硬膜外麻醉下阑尾切除术中牵拉反应效果的比较  

Comparison of dexmedetomidine with pethidine in prevention of visceral traction response during appendectomy with epidural anesthesia

作　　者：李小宝 刘香珠 邹毅清 

机构地区：[1]南京军区福州总院476医院麻醉科,福建福州350001

出　　处：《吉林医学》2016年第8期1895-1897,共3页Jilin Medical Journal

摘　　要：目的：比较右美托咪定和哌替啶预防硬膜外麻醉下阑尾切除术中牵拉反应的效果。方法：急性阑尾炎行硬膜外麻醉患者90例,ASAⅠ~Ⅱ级,按急诊先后,依次循环地归为A、B、C三组,A组患者麻醉平面确定后10 min内泵注右美托咪定1μg/kg、B组患者阑尾牵拉前6 min予哌替啶1 mg/kg、C组患者阑尾牵拉前10 min予生理盐水3 ml。观察阑尾切除过程中的牵拉反射、恶心、呕吐、血压、心率（HR）、平均动脉压（MAP）、血氧饱和度（Sp O2）、寒战的发生率和麻醉深度指数（CSI）。结果：阑尾切除过程中A、B组牵拉反应、寒战发生率较C组降低,差异有统计学意义（P〈0.05）,B、C组恶心、呕吐发生率高于A组,差异有统计学意义（P〈0.05）,给药后7 min、10 min A组HR低于B、C组,给药后5 min、7 min、10 min A组MAP低于B、C组,A组的CSI低于B、C组,差异有统计学意义（P〈0.05）。结论：右美托咪定较哌替啶对预防阑尾切除术中牵拉反应效果更佳。Objective To evaluate the efficacy of dexmedetomidine in prevention of visceral traction response during appendec-tomy with epidural anesthesia.Method 90 cases of acute appendicitis patients with ASA physical statusⅠtoⅡaccording to the arri-val number were assigned to three groups by turn（finally 30 patients each group）.The A group received 1 μg/kg of dexmedetomi-dine through intravenous infusion in 10 min before the stretch of appendix.The B group received pethidine with 1 mg/kg 6 min be-fore the stretch of appendix.The C group received 3 ml saline （the control group）.Blood pressure,heart rate,SpO2 and CSI were recorded,and the incidence of visceral traction,nausea,vomiting,shivering,hypotension,bradycardia during operation were deter-mined and recorded respectively.Results During the appendectomy,incidence of visceral traction and shivering in A and B group was lower than C group,the difference was statistically significant （P 〈0.05）;nausea and vomiting in B and C group was higher than A group,the difference was statistically significant （P 〈0.05）;CSI was lower in A group than in B and C group,the difference was statistically significant （P 〈0.05）.Conclusion Dexmedetomidine is better than pethidine In prevention of visceral traction re-sponse during appendectomy with epidural anesthesia.

关 键 词：右美托咪定 哌替啶 阑尾切除术 牵拉反应 

分 类 号：R614.4[医药卫生—麻醉学]