右美托咪定对静吸复合麻醉骨折手术患者苏醒期躁动及术后机械痛阈值的影响  

Effect of Dexmedetomidine on the Dysphoria during the Recovery Period and Postoperative Mechanical Withdrawal Threshold of Operative Patients with Intravenous Inhalational Anesthesia Fracture

作　　者：王昱 徐敏 孔德强 

机构地区：[1]徐州医科大学附属医院麻醉科,江苏徐州221000

出　　处：《中外医疗》2017年第2期10-12,共3页China & Foreign Medical Treatment

摘　　要：目的探讨使用右美托咪定(Dex)对行静吸复合麻醉手术的骨折患者其苏醒期躁动以及术后机械痛阈值有何影响。方法随机抽取该院2013年1月—2014年1月收治的60例选择静吸复合麻醉手术的骨折患者进行实验观察,采用双盲法将其分为常规组与实验组,各30例,前者于麻醉诱导后注入等容量的生理盐水,后者即刻注入1μg/kg的右美托咪定,观察两组患者拔管时间、苏醒时间、苏醒期躁动发生次数以及苏醒期躁动程度,另外评估患者术后6、24、48 h时各时间段的机械疼痛阈值。结果两组患者在手术一般情况差异无统计学意义(P>0.05);而常规组患者术后出现40%的苏醒期躁动发生率,实验组患者躁动发生率仅为10%;而实验组苏醒期的躁动程度(1.03±0.25)以及术后48 h的机械疼痛阈值(9.15±1.42)均显著优于常规组各指标,对比差异有统计学意义(P<0.05)。结论对行静吸复合麻醉手术的骨折患者使用右美托咪啶可有效减少患者苏醒期躁动的发生率,并降低其躁动程度,同时提高患者术后机械痛阈值,抑制术后痛觉过敏的发生,可列入临床麻醉用药的选择范围内。Objective To discussion the effect of Dexmedetomidine on the dysphoria during the recovery period and postoperative mechanical withdrawal threshold of patients with intravenous inhalational anesthesia fracture. Methods 60 cases of operative patients with intravenous inhalational anesthesia fracture admitted and treated in our hospital from January2013 to January 2014 were observed and divided into two groups with 30 cases in each, the routine group were injected into equivolume salt solution after anesthesia induction, while the experimental group were injected into 1 μg/kg Dexmedetomidine immediately, and the extubation time, recovery time, the frequency of restlessness and the degree of agitation during recovery period of the two groups were observed, and the mechanical withdrawal thresholds at 6, 24 h and 48 h after operation of patients were evaluated. Results The difference in the general operative situation between the two groups had no statistical significance（P0.05）, and the incidence rate of dysphoria during the recovery period was 40% after operation in the routine group and only 10% in the experimental group, and the dysphoria degree during the recovery period and mechanical withdrawal threshold at 48 h after operation were respectively（1.03±0.25） and（9.15±1.42）, which were obviously better than those in the routine group, and the differences had statistical significance（ P 0. 05）. Conclusion The application of Dexmedetomidine for operative patients with intravenous inhalational anesthesia fracture can effectively reduce the incidence rate of dysphoria of patients during the recovery period, reduce the dysphoria degree, improve the postoperative mechanical withdrawal threshold of patients and control the occurrence of postoperative hyperalgia, which can be included into the selection range of clinical anesthetic medication.

关 键 词：骨折 静吸复合麻醉 苏醒躁动期 机械痛阈值 右美托咪啶 影响 

分 类 号：R5[医药卫生—内科学]