右美托咪定对老年患者脊柱手术苏醒期躁动的影响  

Effects of dexmedetomidine on emergence agitation in elderly patients after spinal surgery

作　　者：樊玉花[1] 项明琼[1] 马宇[1] 

机构地区：[1]第二军医大学附属长海医院麻醉科,上海200433

出　　处：《临床外科杂志》2016年第8期626-628,共3页Journal of Clinical Surgery

摘　　要：目的观察右美托咪定对老年患者脊柱手术后苏醒期躁动(EA)的影响。方法老年患者(年龄≥60岁)60例,随机分为右美托咪定组(D组)和对照组(C组),每组30例。麻醉诱导后D组患者持续泵注右美托咪定每小时0.4μg/kg,C组持续泵注等容量的生理盐水,手术结束时停药。入麻醉恢复室(PACU)后进行Richmond躁动镇静(RASS)评分,记录EA发生率。记录患者清醒时间、气管导管拔除时间及PACU停留时间。术后24小时记录患者对苏醒期治疗的满意度。结果 D组患者EA发生率为16.67%,C组为46.67%,两组比较差异有统计学意义(P<0.05),D组患者PACU停留时间为(42.17士17.40)分钟,C组为(52.50±22.12)分钟,两组比较差异有统计学意义(P<0.05)。D组患者清醒时间为(16.67±7.58)分钟,拔管时间为(21.67±7.58)分钟,C组分别为(14.40±8.47)分钟和(19.10±8.86)分钟,两组比较差异无统计学意义(P>0.05)。结论右美托咪定可以有效地降低老年患者脊柱手术后EA发生率,提高患者苏醒质量。Objective To investigate the effects of dexmedetomidine on emergence agitation dur- ing recovery after spinal surgery in elderly patients. Methods A total of 60 elderly patients （ age≥ 60 ） were randomly assigned to dexmedetomidine group （ group D, n = 30 ） and propofol group （ group C, n = 30）. The group D received dexmedetomidine at a rate of μg/（kg· h）from induction of anesthesia until the end of suegery, while the group C received volume-matched saline infusion as placebo. The incidence of agitation, haemodynamic parameters, and recovery characteristics were evaluated in post-anesthesia care unit （PACU）. Rusults The incidence of emergence agitation was lower in group D than group C （16.67% vs 46.67%, n = 0. 013 ）; time to PACU discharge in group D was shorter than group C [ （42.17 ± 17.40） rain vs （52.50 ± 22.12 ） min, n = 0.049 ]. Time to awake and time to extubation were similar between the groups. Conclusion Dexmedetomidine may be an effective intraoperative adjuvant for a reducing emergence agitation from anaesthesia and it may improve the quality of recovery after spinal surgery in elderly patients.

关 键 词：脊柱手术 右美托咪定 苏醒期躁动 老年 

分 类 号：R614[医药卫生—麻醉学]